Successful Open Surgical Repair and Postoperative Complications for Ruptured Abdominal Aortic Aneurysm Transferred with Intra-aortic Balloon Occlusion Catheter / 日本心臓血管外科学会雑誌

A 74-year old man, presented with dyspnea following acute abdominal pain, was admitted to an initial hospital. The plain computed tomography (CT) scan revealed a ruptured abdominal aortic aneurysm (AAA). Emergency insertion of intra-aortic balloon occlusion (IABO) catheter was carried out due to his unstable hemodynamic condition. The patient was transferred to our hospital after surgical consultation. Open surgical repair was carried out, and massive retroperitoneal hematoma and excessive bowel edema made it difficult to close the abdomen primarily. Delayed closure following Open Abdomen Management (OAM) was effective.

Effects of Continuous Descending Aortic Balloon Occlusion on Brain Ischemia during Cardiopulmonary Resuscitation in Rabbits

PURPOSE: A recent report introduce a new option for cardiopulmonary resuscitation by using of a continuous descending aortic balloon occlusion. The aim of the present study was to evaluate the effect of balloon occlusion of the descending aorta during cardiopulmonary resuscitation on brain ischemia. METHODS: Twelve rabbits were enrolled in this study. A 4 French Swan-Ganz catheter was advanced through the right femoral artery into the descending aorta. Ventricular fibrillation was induced with an AC current delivered through an electrode catheter advanced into the right ventricle. After 3 minutes of untreated ventricular fibrillation, the rabbits were randomized in two groups: (1) chest compression without balloon occlusion (control group) and (2) chest compression with balloon occlusion of the descending aorta (experimental group). The balloon was inflated for 3 minutes during resuscitation. Defibrillation was attempted at 3 minutes after start of chest compression. At 24 hours after return of spontaneous circulation, brain tissues were fixed in 4% paraformaldehyde and stained with hematoxylin eosin. Then, the ischemic cells in the hippocampal CA1 area were counted. RESULTS: There was significant difference in ischemic neuronal cells between the two groups (control group: 41.8 +/-10.9%, experimental group: 16.8+/-6.8%, p < 0.05). In the experimental group, carotid blood flow was better than it was in the control group during chest compression (control group: 2.4+/-1.0 mL/min, experimental group: 7.6+/-1.9 mL /min, p < 0.05). CONCLUSION: These results suggests that balloon occlusion of the descending aorta during resuscitation decreases brain ischemia in rabbits during cardiac arrest.