University of Florida College of Medicine, Department of General Internal Medicine, 1600 SW Archer Rd., Gainesville, FL 32610, USA.
University of Florida College of Medicine, Department of Medicine Division of Cardiovascular Medicine, 1600 SW Archer Rd,, Gainesville, FL 32610, USA.
Cardiovasc Revasc Med. 2021 Jul;28S:166-168. doi: 10.1016/j.carrev.2021.04.030. Epub 2021 May 1.
Patients with end-stage heart failure with reduced ejection fraction requiring mechanical support while awaiting heart transplant present a clinical dilemma. Intra-aortic balloon pump (IABPs) provide a modest improvement in hemodynamics and are easy to implant. Left axillary IABP implantation allows patients to engage in daily physical activity pre-transplant. We present a case of a patient awaiting heart transplant with a left axillary IABP that prolapsed above the aortic valve in the ascending aortic root requiring immediate removal. We describe our multi-modal imaging evaluation, and technique to safely remove the IABP and replace a new one into the same left axillary access while preserving vascular access.
等待心脏移植的射血分数降低的终末期心力衰竭患者需要机械支持，这给临床带来了困境。主动脉内球囊反搏（IABP）可适度改善血液动力学，且易于植入。左腋下入路 IABP 植入可使患者在移植前进行日常体力活动。我们报告了一例等待心脏移植的患者，其左腋下入路 IABP 发生脱垂，进入升主动脉根部的主动脉瓣上方，需要立即取出。我们描述了我们的多模态影像学评估方法，以及在保留血管通路的情况下，安全取出 IABP 并更换新的 IABP 进入同一左腋下入路的技术。
