Perforation of the descending aorta by the tip of an intra-aortic balloon pump catheter.
Perforation of the proximal descending aorta occurred in a patient on intra-aortic balloon pump (IABP) support after emergency coronary intervention for acute myocardial infarction. The IABP catheter was inserted under fluoroscopic guidance into the right femoral artery without difficulty, but after 8 h on IABP support the patient went into shock with a left hemothorax. Emergency surgery was performed with cardiopulmonary bypass and a perforation of the proximal descending aorta with active bleeding was found and successfully repaired. A distorted descending aorta in which the IABP catheter was kinked, as in the aortic arch, was discovered during surgery and confirmed postoperatively with 3-dimensional computed tomography scans, particularly in the lateral view. Not only the antero-posterior but also the lateral fluoroscopic view is recommended to prevent aortic perforation by a kinked IABP catheter.
Shiraishi
Ryo
R
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Saga City, Japan.
Okazaki
Yukio
Y
Naito
Kozo
K
Itoh
Tsuyoshi
T
D015906:Angioplasty, Balloon, Coronary; D001012:Aorta, Abdominal / Q000293:injuries*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology* / Q000601:surgery; D004868:Equipment Failure; D006341:Heart Rupture / Q000209:etiology*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery