Open AccessPercutaneous Axillary Intra-aortic Balloon Pump Insertion Technique as Bridge to Advanced Heart Failure Therapy
Author(s) -
Andrew Rosenbaum,
C. Charles Jain,
Ilya Y. Shadrin,
Stephanie C. El Hajj,
Abdallah El Sabbagh,
Atta Behfar
Publication year - 2020
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001259
Subject(s) - medicine , intra aortic balloon pump , percutaneous , surgery , balloon , axillary artery , heart failure , cardiology , complication , destination therapy , intra aortic balloon pumping , transplantation , heart transplantation , cardiogenic shock , myocardial infarction
In patients with advanced heart failure (HF), temporary mechanical circulator support (TMCS) is used to improve hemodynamics, via left ventricular unloading, and end-organ function as a bridge to definitive therapy. While listed for cardiac transplantation, use of TMCS may be prolonged, preventing adequate mobility. Here, we describe the technique for placement of a percutaneous axillary intra-aortic balloon pump (IABP) using single-site arterial access to facilitate ambulation and subsequent safe removal without surgery or a closure device. Retrospective review of the experience with this approach at a single institution between September 2017 and February 2020 documented feasibility and safety. Baseline demographics, hemodynamic data, and clinical outcomes were collected. Thirty-eight patients had a total of 56 IABPs placed. There were no significant access site or cerebrovascular complications. One fifth of IABPs (21.4%) had balloon failure or migration, requiring placement of a new device, though no patients had significant complications from balloon failure. The majority (81.6%) of patients in the cohort on axillary IABP support were ambulatory and ultimately received the intended therapy (63.2% transplant, 13.2% durable left ventricular assist device, 5.3% other cardiac surgery). Percutaneous, axillary IABP is feasible and associated with an acceptable complication rate as a bridge to definitive therapy.