title: Transaortic intra-aortic balloon pump catheter insertion through a separate saphenous vein graft in patients with severe aortoiliac disease.
abstract: BACKGROUND
  Intra-aortic balloon pump (IABP) is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases.
  
  
  METHODS
  This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum.
  
  
  RESULTS
  The procedure was successfully performed in all the patients. The mean duration of IABP support was 54.0 ± 13.4 hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft.
  
  
  CONCLUSIONS
  This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.
authors: Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, 16330 Bursa, Turkey.
authors: Faruk
authors: F
authors: Toktas
authors: Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, 16330 Bursa, Turkey.
authors: Senol
authors: S
authors: Yavuz
authors: Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, 16330 Bursa, Turkey.
authors: Cuneyt
authors: C
authors: Eris
authors: Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Education and Research Hospital, 16330 Bursa, Turkey.
authors: Suleyman
authors: S
authors: Surer
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome