Intra-Aortic Balloon Pump Rupture and Entrapment

Abstract

Intra-aortic balloon pump is used frequently to support a failing myocardium in cardiac patients. Due to the invasive nature of this device, usage is accompanied by consistent risk of complications. Balloon rupture, although it occurs rarely, may lead to entrapment if diagnosis delays. A 78-year male who underwent cardiac surgery experienced balloon rupture and entrapment in the right femoral artery during the postoperative follow-up. Surgical extraction under local anesthesia was performed and the patient had an uneventful course. Fast and gentle solution of the problem is necessary to prevent further morbidity or mortality related to a retained balloon catheter in these delicate patients.

Management of Intra-Aortic Balloon Pump Rupture and Entrapment

“…Local delivery of streptokinase, urokinase, heparin, or tissue plasminogen activator into the gas-driven lumen of the balloon catheter has dissolved the clot within the IABP lumen, enabling a normal percutaneous extraction of the balloon catheter without surgery [6,8]. However, an open surgical approach has been the extraction modality of choice in recent times [6,8,9]. Open inguinal access to the femoral and/or iliac vessels is the mainstay approach for removal of the entrapped IABP due to the ease of access and possibility for safe extraction under direct vision, although successful trans-and retroperitoneal approaches have also been described [7,10].…”