Intra-aortic Balloon Pump As a Bridge to Heart Transplant After Non-ST-Segment-Elevation Myocardial Infarction in Palliated Hypoplastic Left Heart Syndrome

Osula, David; Farris, Gary Ross; Chatterjee, Arka; Law, Mark A.; Cribbs, Marc

doi:10.1161/circheartfailure.119.006130

Cited by 1 publication

(1 citation statement)

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“…To our knowledge, the evidence for the use of intra-aortic balloon pump (IABP) treatment in adult Fontan patients is limited to three case reports. 1–3 Even among children with a Fontan circulation, the use of IABP is a rarity, and in such cases mostly used in the post-operative setting shortly after establishment of Fontan circulation. 3–6 We present an adult Fontan patient with acute pneumonia and heart failure, treated with IABP.…”

Section: Introductionmentioning

confidence: 99%

Intra-aortic balloon pump treatment in an adult patient with a Fontan circulation and acute heart failure: a case report

Langseth,

Nordstrand,

Erikssen

2024

European Heart Journal - Case Reports

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Background There is limited evidence for the use of an intra-aortic balloon pump (IABP) in adult patients with a total cavopulmonary, or Fontan circulation. Case summary A patient in his twenties with a Fontan circulation presented with sepsis, pneumonia, and pulmonary oedema. He was born with a hypoplastic left ventricle, atrioventricular septal defect, and hypoplastic aortic arch, and a total cavopulmonary circulation had been established within his first years of life. Standard of care treatment with antibiotics, non-invasive ventilatory support, loop diuretics, and vasopressors was initiated. Due to persistent pulmonary congestion and increasing general fatigue, an IABP was placed via a femoral artery to offload the failing systemic ventricle. Secondary to IABP treatment, mean arterial pressure rose, and vasodilatory nitroprusside could be introduced. Over 4 days of IABP treatment, the patient’s general condition and ventricular systolic function improved significantly. Discussion This case suggests that IABP treatment was important in the recovery of our patient with a Fontan circulation, pneumonia, and heart failure. We propose that during IABP treatment, an increase in stroke volume and a reduction in ventricular filling pressure is achieved, thereby increasing the transpulmonary pressure gradient that is central to pulmonary blood flow in Fontan patients. More definitive evidence is necessary to confirm our hypotheses.

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Section: Introductionmentioning

confidence: 99%