[Rupture of the intra-aortic balloon during mechanically assisted circulation].

An intra-aortic balloon pump catheter may be used for mechanical support of insufficient heart function. A possible complication is rupture of this balloon. In the last few years, a substantial increase of such ruptures has been observed. In the period between 1 January 1989 and 30 September 1990, 14 balloon ruptures in 10 patients were seen in the University Medical Centre of Amsterdam. The total number of patients treated with an intra-aortic balloon in that period was 101. In most cases the balloon rupture was revealed by the appearance of blood in the connecting tube of the balloon catheter. Rupture frequency was twice as high in females as in males. In none of the patients was the rupture followed by clinical signs of gas embolism. Most ruptures occurred in the distal part of the balloon near or in the abdominal aorta. At examination of the balloons it was found that all perforations had occurred in an area that was scraped, probably by a calcium plaque. The fact that balloon ruptures nowadays occur more often than formerly is probably due to the fact that more patients are operated at advanced ages, with a long history of disease and more aortic sclerosis.