Intra-aortic balloon pump can be used after acute type A aortic dissection repair
Abstract Objectives We analyzed our data to evaluate the safety and feasibility of intraoperative extracorporeal membrane oxygenation and intra-aortic balloon pump use in acute type A aortic dissection repair. Methods Between December 1999-December 2020, we identified patients who received intraoper...
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BMC
2025-08-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03556-x |
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| author | Akiko Tanaka Yuki Ikeno Harleen K. Sandhu Charles C. Miller III Hazim J. Safi Anthony L. Estrera |
| author_facet | Akiko Tanaka Yuki Ikeno Harleen K. Sandhu Charles C. Miller III Hazim J. Safi Anthony L. Estrera |
| author_sort | Akiko Tanaka |
| collection | DOAJ |
| description | Abstract Objectives We analyzed our data to evaluate the safety and feasibility of intraoperative extracorporeal membrane oxygenation and intra-aortic balloon pump use in acute type A aortic dissection repair. Methods Between December 1999-December 2020, we identified patients who received intraoperative extracorporeal membrane oxygenation and/or intra-aortic balloon pump support to wean off cardiopulmonary bypass were retrospectively reviewed. Results A total of 690 patients who underwent acute type A dissection repair. In all, 31 patients received intraoperative circulatory support (11 extracorporeal membrane oxygenation, 20 intra-aortic balloon pump) to wean off cardiopulmonary bypass. In all, 14 patients (45%) were female and the median age was 65 years (interquartile range 51–73). Prior to the acute type A dissection repair, 13 (42%) had coronary malperfusion, 7 (23%) had visceral malperfusion, 4 (13%) presented with acute coronary syndrome, and 8 (26%) received cardiopulmonary resuscitation. The median clamp time was 108 min (interquartile range 89–157) and circulatory arrest time was 25 min (interquartile range 19–31). Concomitant procedures included 11 coronary artery bypass grafting (35%), 4 root replacements (13%) and 1 total arch replacement (3%). Overall, in-hospital mortality was 67%: 10 of 11 (91%) patients with extracorporeal membrane oxygenation and 11 of 19 patients (55%) with intra-aortic balloon pump expired. There were no intra-aortic balloon pump-specific aortic complications (i.e. aortic rupture, extension of dissection). Conclusions Outcomes after extracorporeal membrane oxygenation support in acute type A dissection were discouraging. There may be a role for intra-aortic balloon pump following acute type A dissection repair to allow patients to recover from cardiogenic shock in the selected patients. |
| format | Article |
| id | doaj-art-a7ce6aa991214c39b7c0f7fa1b4f692c |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-a7ce6aa991214c39b7c0f7fa1b4f692c2025-08-24T11:49:47ZengBMCJournal of Cardiothoracic Surgery1749-80902025-08-012011710.1186/s13019-025-03556-xIntra-aortic balloon pump can be used after acute type A aortic dissection repairAkiko Tanaka0Yuki Ikeno1Harleen K. Sandhu2Charles C. Miller III3Hazim J. Safi4Anthony L. Estrera5Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth HoustonDepartment of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth HoustonDepartment of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth HoustonDepartment of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth HoustonDepartment of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth HoustonDepartment of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth HoustonAbstract Objectives We analyzed our data to evaluate the safety and feasibility of intraoperative extracorporeal membrane oxygenation and intra-aortic balloon pump use in acute type A aortic dissection repair. Methods Between December 1999-December 2020, we identified patients who received intraoperative extracorporeal membrane oxygenation and/or intra-aortic balloon pump support to wean off cardiopulmonary bypass were retrospectively reviewed. Results A total of 690 patients who underwent acute type A dissection repair. In all, 31 patients received intraoperative circulatory support (11 extracorporeal membrane oxygenation, 20 intra-aortic balloon pump) to wean off cardiopulmonary bypass. In all, 14 patients (45%) were female and the median age was 65 years (interquartile range 51–73). Prior to the acute type A dissection repair, 13 (42%) had coronary malperfusion, 7 (23%) had visceral malperfusion, 4 (13%) presented with acute coronary syndrome, and 8 (26%) received cardiopulmonary resuscitation. The median clamp time was 108 min (interquartile range 89–157) and circulatory arrest time was 25 min (interquartile range 19–31). Concomitant procedures included 11 coronary artery bypass grafting (35%), 4 root replacements (13%) and 1 total arch replacement (3%). Overall, in-hospital mortality was 67%: 10 of 11 (91%) patients with extracorporeal membrane oxygenation and 11 of 19 patients (55%) with intra-aortic balloon pump expired. There were no intra-aortic balloon pump-specific aortic complications (i.e. aortic rupture, extension of dissection). Conclusions Outcomes after extracorporeal membrane oxygenation support in acute type A dissection were discouraging. There may be a role for intra-aortic balloon pump following acute type A dissection repair to allow patients to recover from cardiogenic shock in the selected patients.https://doi.org/10.1186/s13019-025-03556-xAcute type A aortic dissectionMechanical circulatory supportIntra-aortic balloon pumpExtracorporeal membrane oxygenation |
| spellingShingle | Akiko Tanaka Yuki Ikeno Harleen K. Sandhu Charles C. Miller III Hazim J. Safi Anthony L. Estrera Intra-aortic balloon pump can be used after acute type A aortic dissection repair Journal of Cardiothoracic Surgery Acute type A aortic dissection Mechanical circulatory support Intra-aortic balloon pump Extracorporeal membrane oxygenation |
| title | Intra-aortic balloon pump can be used after acute type A aortic dissection repair |
| title_full | Intra-aortic balloon pump can be used after acute type A aortic dissection repair |
| title_fullStr | Intra-aortic balloon pump can be used after acute type A aortic dissection repair |
| title_full_unstemmed | Intra-aortic balloon pump can be used after acute type A aortic dissection repair |
| title_short | Intra-aortic balloon pump can be used after acute type A aortic dissection repair |
| title_sort | intra aortic balloon pump can be used after acute type a aortic dissection repair |
| topic | Acute type A aortic dissection Mechanical circulatory support Intra-aortic balloon pump Extracorporeal membrane oxygenation |
| url | https://doi.org/10.1186/s13019-025-03556-x |
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