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

Smith, Triston; Shridhar, Puneeth; Khalil, Ramzi; Lasorda, David

doi:10.1136/bcr-2014-208658

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Smith et al 11 reported a case of a patient with ICM who received a percutaneously inserted left brachial IABP for BTT. The patient was weaned from the IABP in 10 days without any complications and received a heart transplant 3 weeks later.…”

Section: Literature Reviewmentioning

confidence: 99%

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use

Nwaejike

Son

Patel

et al. 2017

Innovations�(Phila)

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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 post-cardiotomy 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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Section: Literature Reviewmentioning

confidence: 99%

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use

Nwaejike

Son

Patel

et al. 2017

Innovations�(Phila)

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“…Heart transplantation is an effective method to treat end‐stage heart diseases . The main factor restricting heart transplantation is the lack of suitable donors .…”

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confidence: 99%

Myocardial protective effects of a c‐Jun N‐terminal kinase inhibitor in rats with brain death

Guo

Cao

Yan³

et al. 2016

J Cellular Molecular Medi

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To investigate whether the mitochondrial apoptotic pathway mediates myocardial cell injuries in rats under brain death (BD), and observe the effects and mechanisms of the c‐Jun N‐terminal kinase (JNK) inhibitor SP600125 on cell death in the heart. Forty healthy male Sprague‐Dawley (SD) rats were randomized into four groups: sham group (dural external catheter with no BD); BD group (maintain the induced BD state for 6 hrs); BD + SP600125 group (intraperitoneal injection of SP600125 10 mg/kg 1 hr before inducing BD, and maintain BD for 6 hrs); and BD + Dimethyl Sulphoxide (DMSO) group (intraperitoneal injection of DMSO 1 hr before inducing BD, and maintain BD for 6 hrs). Real‐time quantitative PCR was used to evaluate mRNA levels of Cyt‐c and caspase‐3. Western blot analysis was performed to examine the levels of mitochondrial apoptosis‐related proteins p‐JNK, Bcl‐2, Bax, Cyt‐c and Caspase‐3. TUNEL assay was employed to evaluate myocardial apoptosis. Compared with the sham group, the BD group exhibited increased mitochondrial apoptosis‐related gene expression, accompanied by the elevation of p‐JNK expression and myocardial apoptosis. As the vehicle control, DMSO had no treatment effects. The BD + SP600125 group had decreased p‐JNK expression, and reduced mitochondrial apoptosis‐related gene expression. Furthermore, the apoptosis rate of myocardial cells was reduced. The JNK inhibitor SP600125 could protect myocardial cells under BD through the inhibition of mitochondrial apoptosis‐related pathways.

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A case of ultra-prolonged intra-aortic balloon pump support via sheathless femoral access

Al-Ani,

Snipes,

Parker

et al. 2023

European Heart Journal - Case Reports

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Background Intra-aortic balloon pump (IABP) is a mechanical circulatory support platform with a relatively low complication rate. Axillary access is increasingly utilized to allow rehabilitation. Case Summary We present a case of femoral IABP inserted into the femoral artery percutaneously via a sheathless technique that allowed the patient to ambulate and physically rehabilitate over 102 days until cardiac transplantation. The patient was able to progress with protocolized rehabilitation program to up 3500 feet walking distance. The IABP was removed at the time of transplantation without any vascular complications. Discussion While axillary IABP offers opportunity to rehabilitate, it has an unacceptably high complication rate, often resulting in vascular injury that adds morbidity to an acutely ill cohort. In this case, we found that the sheathless femoral IABP access offered stability for prolonged time while avoiding pain, bleeding, infection, and vascular injury. We hypothesize that this is due to less indwelling prosthetic material usage and also the device flexibility allowing conformation to the natural course of the femoral artery. We are encouraged by this case to use sheathless access approach for patients expected to require prolonged IABP support.

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

Cited by 3 publications

References 12 publications

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use

Myocardial protective effects of a c‐Jun N‐terminal kinase inhibitor in rats with brain death

A case of ultra-prolonged intra-aortic balloon pump support via sheathless femoral access

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