| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2001;72:975
© 2001 The Society of Thoracic Surgeons
a Division of Thoracic and Cardiovascular Surgery, Department of Surgery, and Department of Cardiology, University of Virginia Health System, Charlottesville, Virginia, USA
Address reprint requests to Dr
Tribble, University of Virginia Health System, Box 801359,
Charlottesville, VA 22988
e-mail: ctribble{at}virginia.edu
As Originally Published in 1994: Ambulatory Intraaortic Balloon Counterpulsation by Scott A. Buchanan, MD, Scott E. Langenburg, MD, Michael C. Mauney, MD, Lorne H. Blackbourne, MD, Mark A. Groh, MD, James D. Bergin, MD, and Curtis G. Tribble, MD. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia.
A technique is described for the retroperitoneal placement of a balloon pump that preserves patient mobility. This technique may be superior to standard femoral placement when prolonged support is required for cardiac transplant candidates awaiting donor organs.
Updated in 2001:
In 1994, we reported a technique for intraaortic balloon pump (IABP) insertion that permits substantial mobility of patients with heart failure who are awaiting transplantation [1]. Currently, we do not routinely use balloon counterpulsation for prolonged mechanical support in these patients. In recent years, we have favored the use of implantable ventricular assist devices (VADs) in this setting. However, we have adapted the technique of suturing polytetrafluoroethylene conduits around cannulas to help minimize bleeding in patients on extracorporeal membrane oxygenation or VAD support [2].
Despite a shift in our practice toward VADs, suprainguinal IABP insertion into the iliac artery through a polytetrafluoroethylene conduit can be useful in certain situations. Implantable IABPs remain a viable option in managing patients with end-stage heart failure at centers that do not have an active VAD program. Patients with active infections, who consequently are not ideal candidates for immediate VAD placement, could potentially benefit from an ambulatory IABP as a bridge to VAD insertion. An implantable IABP could be used in patients with left upper quadrant considerations such as stomas or open wounds in whom VAD insertion is not technically feasible and could be considered for other patients who are not candidates for a VAD. Furthermore, the technique of placing a polytetrafluoroethylene conduit around the IABP shaft and suturing it to the adventitia of the aorta continues to be extremely useful to minimize bleeding and facilitate removal when an IABP is inserted through the proximal aorta in an open-chest setting.
In summary, the ambulatory IABP insertion remains a valuable option in the evolving choice of treatments available for managing end-stage heart failure. This is especially true when VAD placement is not feasible. The principles of our technique for IABP insertion have been extended to other applications at our institution to help minimize bleeding and simplify decannulation.
References
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
