Partial right atrial inflow occlusion for controlled systemic hypotension during thoracic endovascular aortic repair.
Controlled hypotension is sometimes necessary for accurate endograft deployment and adjunctive ballooning and stenting near the arch and proximal descending thoracic aorta. This article describes a technique in which a compliant occlusion balloon inflated in the right atrium is used to occlude the inflow from the inferior vena cava and reduce the cardiac preload. This reliably and effectively induces systemic hypotension to any desired level and is also able to be rapidly reversed. The technique has been used in 11 cases of thoracic endovascular aortic repairs with complete success and no procedure-related complications.
Lee
W Anthony
WA
Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Fla, USA. anthony.lee@surgery.ufl.edu
Martin
Tomas D
TD
Gravenstein
Nikolaus
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000628:therapy*; D000792:Angiography / Q000379:methods; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000628:therapy*; D021721:Balloon Occlusion / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006801:Humans; D007023:Hypotension, Controlled / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D018570:Risk Assessment; D016896:Treatment Outcome