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The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review.

Publication ,  Journal Article
Nwaejike, N; Son, AY; Patel, CB; Schroder, JN; Milano, CA; Daneshmand, MA
Published in: Innovations (Phila)
2017

We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta. Three patients were transferred from outside facilities, requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure. Patients included a 54-year-old woman with occluded grafts and left ventricular thrombus after coronary artery bypass grafting, ejection fraction (EF) of 23.4% on dobutamine infusion, intra-aortic balloon pump support for 39 days, max daily ambulated distance of 1250 feet, and discharged home on day 51 on milrinone infusion; a 63-year-old man with kinked left internal mammary artery to left anterior descending artery graft (surgically repaired), multiple failed extubations requiring tracheostomy, EF of 15% on epinephrine and milrinone, intra-aortic balloon pump support for 43 days, max daily ambulated distance of 400 feet, and discharged home on day 54; and a 66-year-old man after redo coronary artery bypass grafting + carotid endarterectomy, with failure to wean off cardiopulmonary bypass requiring veno-arterial extracorporeal membrane oxygenator, EF of 20% on epinephrine and norepinephrine, intra-aortic balloon pump support for 41 days, max daily ambulated distance of 2800 feet, and discharged home on day 91. There were no infection, thromboembolic, cerebrovascular, bleeding, or intra-aortic balloon pump malpositioning/migration complications. We found that transaxillary artery intra-aortic balloon pump is well tolerated by patients and allows early ambulation and aggressive physical therapy in patients needing extended support. Duration of intra-aortic balloon pump support was up to 43 days with no complications.

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Published In

Innovations (Phila)

DOI

EISSN

1559-0879

Publication Date

2017

Volume

12

Issue

6

Start / End Page

472 / 478

Location

United States

Related Subject Headings

  • Thrombosis
  • Stroke Volume
  • Respiratory System
  • Prosthesis Implantation
  • Postoperative Complications
  • Middle Aged
  • Male
  • Intra-Aortic Balloon Pumping
  • Internal Mammary-Coronary Artery Anastomosis
  • Humans
 

Citation

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ICMJE
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Nwaejike, N., Son, A. Y., Patel, C. B., Schroder, J. N., Milano, C. A., & Daneshmand, M. A. (2017). The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review. Innovations (Phila), 12(6), 472–478. https://doi.org/10.1097/IMI.0000000000000432
Nwaejike, Nnamdi, Andre Y. Son, Chetan B. Patel, Jacob N. Schroder, Carmelo A. Milano, and Mani A. Daneshmand. “The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review.Innovations (Phila) 12, no. 6 (2017): 472–78. https://doi.org/10.1097/IMI.0000000000000432.
Nwaejike N, Son AY, Patel CB, Schroder JN, Milano CA, Daneshmand MA. The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review. Innovations (Phila). 2017;12(6):472–8.
Nwaejike, Nnamdi, et al. “The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review.Innovations (Phila), vol. 12, no. 6, 2017, pp. 472–78. Pubmed, doi:10.1097/IMI.0000000000000432.
Nwaejike N, Son AY, Patel CB, Schroder JN, Milano CA, Daneshmand MA. The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review. Innovations (Phila). 2017;12(6):472–478.

Published In

Innovations (Phila)

DOI

EISSN

1559-0879

Publication Date

2017

Volume

12

Issue

6

Start / End Page

472 / 478

Location

United States

Related Subject Headings

  • Thrombosis
  • Stroke Volume
  • Respiratory System
  • Prosthesis Implantation
  • Postoperative Complications
  • Middle Aged
  • Male
  • Intra-Aortic Balloon Pumping
  • Internal Mammary-Coronary Artery Anastomosis
  • Humans