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Intra-aortic balloon pump (IABP) is a bridge to definitive management in a patient with compromised systolic function. It is a life-saving mechanical support to the failing myocardium. It is a procedure that should be employed judiciously with utmost caution. In this correspondence, we aim to highlight a rather serious complication associated with IABP use. A patient with triple vessel disease was posted for coronary artery bypass grafting with poor left ventricular function (ejection fraction 30%) and previous myocardial infarction 4 months back. An IABP was inserted in the left femoral artery following which he developed irreversible ischemia of the left lower limb leading to amputation of the limb. This catastrophic complication is one of the most dreaded impediments in the use of IABP. The clinician needs to weigh the pros and cons carefully and employ this vital procedure only when its use is explicitly justified.
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http://dx.doi.org/10.4103/0259-1162.171442 | DOI Listing |
J Cardiovasc Transl Res
December 2024
Department of Cardiovascular Surgery, The Yancheng School of Clinical Medicine of Nanjing Medical University, 02 Xinduxi Road, Yancheng, 224000, China.
This study aimed to construct machine learning models and predict prolonged intensive care units (ICU) stay in patients receiving perioperative intra-aortic balloon pump (IABP) therapy during cardiac surgery. 236 patients were divided into the normal (≤ 14 days) and prolonged (> 14 days) ICU groups based on the 75th percentile of ICU duration across the entire cohort. Seven machine learning models were trained and validated.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Department of Cardiology, University Hospital Waterford, Waterford, Ireland.
Background: Acute myocardial infarction-related cardiogenic shock (AMICS) is a severe complication associated with exceedingly high mortality rates. While mechanical circulatory support (MCS) has emerged as a potential intervention, the evidence base for independent MCS use remains weak. In contrast, systematic reviews of observational studies have revealed significant mortality reduction when a combination of MCS was used: VA-ECMO in conjunction with a left ventricular (LV) unloading device (Impella or IABP).
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Cardiology Department, Belinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
Background: Although the latest studies failed to prove the benefit of routine intra-aortic balloon pump (IABP) use in patients with acute myocardial infarction (MI) presenting with cardiogenic shock, the benefit of IABP utilization in selected cases in "real world" practice is unknown.
Aims: We sought to follow temporal trends in IABP use in a real-world cohort of acute coronary syndrome (ACS).
Methods: We evaluated IABP utilization and patient outcomes from the Acute Coronary Syndrome in Israel Survey (ACSIS) between the years 2000 and 2021.
Am J Case Rep
December 2024
Department of Anesthesiology, Rhode Island Hospital, Providence, RI, USA.
BACKGROUND Congenital pericardial agenesis is a rare condition that is frequently associated with abnormal intrathoracic anatomy, especially malpositioning of the heart within the thoracic cavity. In the setting of coronary artery bypass, these anatomic derangements can present surgical challenges that can necessitate incorporating complementary, non-surgical solutions for complete revascularization. CASE REPORT A 48-year-old male patient presented with acute anginal symptoms, with workup revealing severe, multivessel coronary artery disease, as well as partial absence of the pericardium.
View Article and Find Full Text PDFJACC Case Rep
November 2024
Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.
A 66-year-old man presented with chills, exertional dyspnea, and palpitations; he later developed a fever. Because of his elevated cardiac enzymes and electrocardiography and coronary angiography findings, he was diagnosed with acute myocarditis. Given his unstable hemodynamics, an intra-aortic balloon pump was inserted; however, he experienced a hemodynamic collapse due to refractory ventricular fibrillation.
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