ABSTRACT
A patient with left ventricular power failure after aortocoronary saphenous vein bypass was successfully managed by intraaortic dual-chambered balloon counterpulsation through the ascending aorta. This insertion route reverses the orientation of the spherical distal chamber, which inflates early in diastole and partially occludes the aorta. This position achieved an effective augmentation pressure during left ventricular diastole and reduced arterial end-diastolic pressure considerably. The technique of insertion and events at operation and postoperatively are discussed.
Subject(s)
Aorta , Assisted Circulation/methods , Coronary Artery Bypass , Aged , Blood Pressure , Cardiac Output , Coronary Disease/etiology , Coronary Disease/physiopathology , Coronary Disease/therapy , Humans , Male , Postoperative Complications/therapyABSTRACT
Over a two-year period, 18 patients with postinfarction ventricular aneurysms were treated surgically. There were no operative or early deaths, and only one (5.5%) late (20 months) death. The indications for surgery included angina, congestive heart failure, and serious arrhythmias. Electrocardiograms and plain chest roentgenograms were unreliable in making the diagnosis. All patients had cardiac catheterization and, at operation, a definite localized aneurysm was demonstrable. In 15 patients (83%), coronary artery bypass grafts were performed at the time the aneurysm was excised. Good results should be expected from surgical treatment of symptomatic ventricular aneurysms. Simultaneous bypass grafting should be performed when indicated.
