Page 1 :
642, JACC May 11, 2021, Volume 77, Issue 18, , Heart Failure and Cardiomyopathies, VASCULAR COMPLICATIONS OF PERCUTANEOUS AXILLARY INTRA-AORTIC BALLOON PUMP, THERAPY, Poster Contributions, Saturday, May 15, 2021, 12:15 p.m.-1:00 p.m., Session Title: Heart Failure and Cardiomyopathies: Mechanical Support and Cardiac Transplantation 1, Abstract Category: 10. Heart Failure and Cardiomyopathies: Mechanical Support and Cardiac Transplantation, Authors: Hidefumi Nishida, Tae Song, David Onsager, Ann Nguyen, Jonathan Grinstein, Bow Chung, Bryan Smith, Sara Kalantari, Nitasha, Sarswat, Gene Kim, Sean Pinney, Valluvan Jeevanandam, Ross Milner, Takeyoshi Ota, University of Chicago Medicine, Chicago, IL, USA, Background: Axillary Intra-aortic balloon pump (Ax IABP) has been increasingly utilized for hemodynamic support in heart failure patients., Vascular complications associated with Ax IABP such as dissection or rupture are relatively rare but could adversely affect clinical, outcomes., Methods: Between June 2016 and November 2020, 199 patients underwent percutaneous Ax IABP placement. Six patients (6/199, 3.0%), were complicated with aortic/arterial dissection or rupture during the procedures or the course of treatment., Results: Patient 1 underwent Ax IABP as a bridge to heart transplantation(BTT) and subsequently required an IABP exchange which was, complicated with a Type A dissection confirmed by a Computed tomography angiography(CTA). We performed an emergent left ventricular, assist device(LVAD) surgery and ascending aorta replacement. Patient 2 underwent Ax IABP as a bridge to LVAD. The procedure was, aborted due to a difficulty in advancing a guidewire. A CTA showed a type A dissection and emergent LVAD surgery was performed. Patient, 3 underwent Ax IABP as BTT and required an exchange due to a kinking. During procedure, the patient started having a back pain and, CTA showed a descending aortic rupture. Emergent endovascular therapy was performed. Patient 4 underwent Ax IABP as a support for, heart failure. A left subclavian artery dissection was incidentally found. It was medically treated. Patient 5 successfully underwent Ax IABP, as BTT. The patient complained of acute back pain at postoperative day 7. CTA showed the IABP tip penetrated though the abdominal, aorta along with a type B dissection. Emergent endovascular therapy was performed. Patient 6 underwent Ax IABP as BTT. After, transplantation, the IABP was removed using a vascular closure device. It was noted that the left arm was cooler than the right side. CTA, revealed a left subclavian artery dissection. This was medically treated. The postoperative/treatment course was uneventful in all patients., Conclusion: Percutaneous Ax IABP infrequently causes significant vascular complications. Although the incidence is low, knowledge of, and prompt recognition of this potential complication is important to reduce more significant adverse outcomes., , Downloaded for Abhishek Srivastava ([email protected]) at Fortis Escorts Heart Institute and Research Centre from ClinicalKey.com by, Elsevier on December 02, 2021. For personal use only. No other uses without permission. Copyright ©2021. Elsevier Inc. All rights reserved.