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Case Reports
. 2023 May 17;15(5):e39122.
doi: 10.7759/cureus.39122. eCollection 2023 May.

Aortic Dissection From an Intra-aortic Balloon Pump: A Dangerous Complication to Keep in Mind

Ivan A Mijares-Rojas  1 , Luis G Trujillo  1 , Paola A Lecompte-Osorio  1 , Enrique F Martinez Trevino  2 , Mrudula Munagala  3
Affiliations
Case Reports

Aortic Dissection From an Intra-aortic Balloon Pump: A Dangerous Complication to Keep in Mind

Ivan A Mijares-Rojas et al. Cureus. .

Abstract

Despite the benefits of the intra-aortic balloon pump (IABP) being a subject of debate, it remains a widely available and easy-to-use mechanical circulatory support device. Nonetheless, its use is not exempt from complications. Aortic dissection from IABP is an infrequent but deathly complication. We describe a case in which early recognition of the condition led to control through an endovascular approach. A 57-year-old male was admitted for acute decompensated heart failure requiring intravenous inotropic agents. While undergoing assessment for a heart transplant, he developed cardiogenic shock requiring initiation of mechanical circulatory support with an IABP. A few hours after device implantation, the patient developed acute tearing chest pain and was found to have an acute dissection in the descending thoracic aorta. Prompt liaison with the endovascular team led to a thoracic endovascular aortic repair to control the extent of the lesion.

Keywords: aortic dissection management; intra-aortic balloon pump; intra-aortic balloon pump (iabp); mechanical circulatory assistant devices; thoracic aortic dissection; thoracic endovascular aortic repair.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Chest X-ray (anteroposterior view) demonstrating the intra-aortic balloon pump catheter tip (yellow arrow) positioned approximately 1.6 cm from the aortic knuckle.
Figure 2
Figure 2. Parasagittal view of CT angiogram demonstrating a tear within the descending aorta with hematoma formation (yellow arrow). Intra-aortic balloon pump catheter tip (red arrow) and balloon (green arrow).
Figure 3
Figure 3. CT (axial view) demonstrating the aortic tear (yellow arrow) and surrounding hematoma formation (red arrowheads).
Figure 4
Figure 4. CT angiogram (parasagittal view) demonstrating the presence of a stent graft covering the lesion area at the descending aorta (yellow arrow) and extending distally to cover the intra-aortic balloon pump device.
Figure 5
Figure 5. Axial CT cut demonstrating the covering of the lesion with the stent graft (yellow arrow), preventing hematoma enlargement (red arrowheads).
See this image and copyright information in PMC

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