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Case Reports
. 2015 Feb 5:2015:bcr2014208658.
doi: 10.1136/bcr-2014-208658.

Prolonged duration of transbrachial intra-aortic balloon pump as bridge to heart transplantation

Triston B B J Smith  1 , Puneeth Shridhar  1 , Ramzi Khalil  1 , David Michael Lasorda  1
Affiliations
Case Reports

Prolonged duration of transbrachial intra-aortic balloon pump as bridge to heart transplantation

Triston B B J Smith et al. BMJ Case Rep. .

Abstract

We describe a case demonstrating the quality of life (QOL) benefit and safety of using a transbrachial approach for insertion of an intra-aortic balloon pump (IABP) in a patient awaiting cardiac transplantation. A 68-year-old man with ischaemic cardiomyopathy was admitted to our cardiac intensive care unit to await the availability of a suitable donor organ for orthotopic heart transplant. An IABP was needed for haemodynamic support due to cardiogenic shock. Since the patient did not want to be committed to lying supine in bed for multiple days, as would have been the case had the IABP been placed using the conventional femoral route, we inserted a 7.5 Fr 'sheathless' IABP via the transbrachial approach. The patient's haemodynamics improved and the device was left in place for 240 h without vascular compromise. He was subsequently successfully transplanted and is doing well on follow-up.

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Figures

Figure 1
Figure 1
Transbrachial access for intra-aortic balloon pump (IABP) support. Haemoband device in place (white arrow).
Figure 2
Figure 2
The patient is ambulatory to the chair and appears comfortable.
Figure 3
Figure 3
Duplex ultrasound showing normal flow in the left brachial artery.
See this image and copyright information in PMC

References

    1. Cheng JM, den Uil CA, Hoeks SE et al. . Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials. Eur Heart J 2009;30:2102–8. 10.1093/eurheartj/ehp292 - DOI - PubMed
    1. Burack JH, Uceda P, Cunningham JN Jr. Transthoracic intraaortic balloon pump: a simplified technique. Ann Thorac Surg 1996;62:299–301. 10.1016/0003-4975(96)00245-7 - DOI - PubMed
    1. H'Doubler PB Jr, H'Doubler WZ, Bien RC et al. . A novel technique for intraaortic balloon pump placement via the left axillary artery in patients awaiting cardiac transplantation. Cardiovasc Surg 2000;8:463–5. 10.1016/S0967-2109(00)00052-1 - DOI - PubMed
    1. Estep JD, Cordero-Reyes AM, Bhimaraj A et al. . Percutaneous placement of an intra-aortic balloon pump in the left axillary/subclavian position provides safe, ambulatory long-term support as bridge to heart transplantation. JACC Heart Fail 2013;1:382–8. 10.1016/j.jchf.2013.06.002 - DOI - PubMed
    1. Okai I, Inoue K, Maruyama M et al. . Transbrachial intra-aortic balloon pumping for a patient with fulminant myocarditis. Heart Vessels 2012;27:639–42. 10.1007/s00380-012-0231-z - DOI - PubMed

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