The use of intra-aortic balloon pump after surgical treatment of DeBakey type I dissecting aneurysm of the aorta.
The case is reported of a sixty-four-year-old patient with DeBakey type I aortic dissection in whom postoperative extensive intra-aortic balloon pumping was applied. Surgical repair involved replacing the ascending aorta with a Medtronic Hall valved conduit. After surgery severe low-output syndrome occurred. Despite the use of high-dose inotropic drugs the patient could not be hemodynamically stabilized. An intra-aortic balloon pump was finally applied as a therapeutical last resort. Within three days, under counterpulsation, the patient reached a stable hemodynamic condition. After twenty-one days in the intensive care unit, he could be transferred to a normal ward. The patient was discharged on the fifty-fourth postoperative day. During counterpulsation there were no balloon- or catheter-induced complications. Follow-up at five months showed the patient in good general health: echocardiography did not identify any lesions of the thoracic aorta which could be linked to counter-pulsation. It is concluded that the postoperative use of intra-aortic balloon pump in the event of DeBakey type I dissecting aneurysm of the aorta, and adversely affected patient hemodynamics, is a justifiable therapeutical alternative.
Vicol
C
C
Department of Cardiac Surgery, Zentralklinikum Augsburg, Germany.
Roth
A
A
Struck
E
E
D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D002303:Cardiac Output, Low / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*