Application of Intra-Aortic Balloon Pump in Resection and Anastomosis of Trachea

Zargham Hossein Ahmadi, Amir Ali Rahnemai-Azar, Mohammad Behgam Shadmehr, Tahereh Parsa, Neda Behzadnia, Zahra Ansari Aval, Bahareh Mokri, Hamideh Gholamhoseini

Pediatric Respiratory Diseases Research Centre, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Background: The intra-aortic balloon pump (IABP) is a mechanical device used to assist cardiac circulatory function in patients suffering from cardiogenic shock, congestive heart failure, refractory angina and complications of myocardial infarction. While using IABP in cardiac surgery is well established, there are few studies on the utility of IABP support in high-risk cardiac patients undergoing non-cardiac surgery. Major non-cardiac surgeries are associated with high rates of cardiac complications in patients with advanced coronary disease. Recent case studies have reported favorable outcomes with the use of IABP support in non-cardiac surgery in patients with severe cardiac compromise. Using IABP may reduce cardiac complications by providing hemodynamic stability.

Materials and Methods: Here, we present five cases of IABP use in high-risk cardiac patients undergoing resection and anastomosis of the trachea. IABP was inserted prior to induction of anesthesia in four of the cases, while IABP insertion was withheld in one case.

Results: In the four cases where IABP support was utilized, the IABP was removed between 6-48 hours postoperatively with no complications.
The patient who did not undergo IABP insertion died on the 8th postoperative day due to uncontrollable pulmonary edema and progressive myocardial infarction.

Conclusions: We also review the literature and discuss the role of IABP use in non-cardiac surgery.
Keywords: Intra-Aortic Balloon Pump, Heart Failure, Resection and Anastomosis of Trachea

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Tanaffos 2014; 13(1): 48-51