loon counterpulsation, amrinone lactate (5 mg' kg-' min-), and norepinephrine. (0.05 mg kg-' min') were necessary to wean the patient from extracorporeal cir-.
Case Reports
Retained lntraaortic Balloon Case Report and Review of the Literature
Antonino M. Grande, MD Luigi Martinelli, MD Angelo Graffigna, MD Mario Vigano, MD
We report a case of intraaortic balloon entrapment in a 70-year-old man who underwent emergency triple coronary bypass. Intraaortic balloon rupture caused the formation of a clot inside the balloon that eventually was responsible for the balloon 's entrapment at the aortic bifurcation. The patient had severe atherosclerosis of the aorta and iliac arteries. Balloon removal required aorto-iliac exposure and aorto-bifemoral bypass. After 16 months, he is symptom free and at home. (Tex Heart Inst J 1995;22:332-4)
eounterpulsation is the most common method of mechanical circulatory support based on augmentation of diastolic pressure to increase coronary artery perfusion. The techniques of intraaortic balloon (IAB) counterpulsation have not changed since their 1st clinical application. by Kantrowitz in 1968.' Intraaortic balloon counterpulsation is commonly used in management of acute left ventricular insufficiency, which occurs in about 1% to 8% of cardiac surgical procedures.2'3 The incidence of IAB ruipture ranges between 0 and 3.50%o,j and a tardive perforation is probably due to prolonged pulsation of the balloon C
against an atherosclerotic plaque. Rupture of the IAB can also lism.'6 Intraaortic balloon entrapment is a very rare event.
cause gas embo-
Case Report
Key words: Intra-aortic balloon pumping; rupture From: Divisione di Cardiochirurgia, Istituto Chirurgia Generale e del Trapianti d'Organo, IRCCS Policlinico "San Matteo," Universita degli Studi di Pavvia, Pavia, Italy Address for reprints: Antonino M. Grande, MD, Divisione di Cardiochirurgia, IRCCS Policlinico "San Matteo," Universita degli Studi di Pavvia, Piazzale Golgi 2, 27100 Pavia, Italy 332
In April of 1994. a 70-year-old man affected by acute anterior myocardial infarction, significant stenosis of the left main coronary artery, and severe depression of left ventricular function (ejection fraction
