Closed-chest decannulation of transthoracically inserted aortic balloon catheter without grafting

Abstract

A method is presented which allows removal of a balloon assist catheter inserted directly (without a graft) through the ascending aorta in the course of heart surgery without the need for reopening the sternotomy incision. The catheter is inserted through the aortic wall under the protection of two purse string sutures which are temporarily tightened using implantable grade silastic rubber tourniquet. The end of the tourniquet is placed subcutaneously in a subxiphoid position. At the time of discontinuation of balloon assist, the balloon can be removed using local anesthesia without reopening the sternum by exposing the end of the tourniquet substernally, removing the catheter, and plugging the tourniquet. The silastic tourniquet may be left in indefinitely or removed through a similar exposure six to eight weeks after the procedure.