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Abrupt change in the shape of a left ventricular mural thrombus after intra-aortic balloon pump-supported percutaneous coronary intervention in recent myocardial infarction.

ABSTRACT: A 77-year-old woman was diagnosed with congestive heart failure and broad anterior acute myocardial infarction that had occurred 10 days prior to her presentation in our hospital. A flat and immobile thrombus was widely attached to the luminal surface of the left ventricular antero-apical wall with dyskinetic motion. For treatment-resistant heart failure, the patient underwent percutaneous coronary intervention (PCI), with intravenous heparin, supporting an intra-aortic balloon pump. Echocardiography obtained 3 h after the procedure revealed that the left ventricular mural thrombus had changed to a centrally hollow, ball-like shape of 4 cm in diameter. The thrombus was surgically removed and left ventriculo-plasty was simultaneously performed without any systemic embolic events. Physicians should be aware that a relatively fresh left ventricular mural thrombus, even with no protrusion or immobility, may peel away from the endocardium after introducing an intra-aortic balloon pump under an optimal anticoagulation for performing PCI. <Learning objective: When determining the therapeutic strategy for congestive heart failure following a recent myocardial infarction with a large, fresh mural thrombus in a left ventricular aneurysm, physicians should be aware that the thrombus, even with no protrusion or immobility, may peel away from the endocardium.>.

SUBMITTER: Toyoda Y

PROVIDER: S-EPMC6279687 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump.

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| S-EPMC6859285 | biostudies-literature

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| S-EPMC7444810 | biostudies-literature

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| S-EPMC7745888 | biostudies-literature

Unilateral Headache Status after Intra-Aortic Balloon Pump Placement.

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Undiagnosed aortic dissection in patient with intra-aortic balloon pump.

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Intra-aortic and Intra-caval Balloon Pump Devices in Experimental Non-traumatic Cardiac Arrest and Cardiopulmonary Resuscitation.

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| S-EPMC10480270 | biostudies-literature

Predicting Hemodynamic Changes During Intra-Aortic Balloon Pump Support With a Longitudinal Evaluation.

Project description:The use of intra-aortic balloon pump (IABP) has decreased in recent years due to negative outcome studies in cardiogenic shock complicating acute myocardial infarction, despite its favorable adverse-event profile. Acute hemodynamic response studies have identified potential super-responders with immediate improvements in cardiac index (CI) in heart failure patients. This single-center retrospective study aimed to predict CI and mean arterial pressure (MAP) changes throughout the entire duration of IABP support. The study analyzed 336 patients who received IABP between 2016 and 2022. Linear mixed-effect regression models were used to predict CI and MAP improvement during IABP support. The results showed that CI and MAP increases during the first days of support, and changes during IABP support varied with time and were associated with baseline parameters. Longitudinal CI change was associated with body surface area, baseline CI, baseline pulmonary artery pulsatility index, baseline need for pressors, and diabetes. Longitudinal MAP change was associated with baseline MAP, baseline heart rate, need for pressors, or inotropes. The study recommends considering these parameters when deciding if IABP is the most appropriate form of support for a specific patient. Further prospective studies are needed to validate the findings.

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Effects of intra-aortic balloon counterpulsation pump on mortality of acute myocardial infarction.

Project description:BackgroundSeveral randomized controlled trials (RCTs) have evaluated the effect of intra-aortic balloon counterpulsation pump(IABP) on the mortality of acute myocardial infarction (AMI).ObjectivesTo analyze the relevant RCT data on the effect of IABP on mortality and the occurrence of bleeding in AMI.Data sourcesPublished RCTs on the treatment of AMI by IABP were retrieved in searches of Medline, EMBASE, Cochrane and other related databases. The last search was conducted on July 20, 2014.Study eligibility criteriaRandomized clinical trials comparing IABP to controls as treatment for AMI.ParticipantsPatients with AMI.Synthesis methodsThe primary endpoint was mortality, and the secondary endpoint was bleeding events. To account for to heterogeneity, a random-effects model was used to analyze the study data.ResultsTen trials with a total population of 973 patients that were included in the analysis showed no significant difference in 2-month mortality between the IABP and the control groups. The 6-month mortality in the IABP group was not significantly lower than in the control group in the four RCTs that enrolled 59 AMI patients with CS. But in the four that enrolled AMI 66 patients without CS, the data showed opposite conclusion.ConclusionsIABP cannot reduce within 2 months and 6-12 months mortality of AMI patients with CS as well as within 2 months mortality of AMI patients without CS, but can reduce 6-12 months mortality of AMI patients without CS. In addition, IABP can increase the risk of bleeding.

| S-EPMC4182463 | biostudies-literature

Intra-Aortic Balloon Pump Bridging to Heart Transplantation: Impact of the 2018 Allocation Change.

Project description:BackgroundThis study evaluates the impact of the 2018 allocation policy change on outcomes of orthotopic heart transplantation (OHT) in patients bridged with intra-aortic balloon pumps (IABPs).MethodsAdult (≥18 years) patients undergoing OHT between 2013 and 2019 who were bridged with an IABP were stratified based on temporal relation to the policy change. Univariate analysis was used to compare baseline characteristics and postoperative outcomes. Multivariate Cox regression analysis was used to estimate risk-adjusted predictors of post-transplant mortality.ResultsA total of 1342 (8.6%) OHT patients were bridged with an IABP during the study period. Rates of bridging with IABP to OHT increased significantly after the policy change (7.0% versus 24.9%, P<0.001). The mean recipient age was 54.1±12.1 years with 981 (73.1%) patients being male. Baseline characteristics were similar between the 2 groups whereas post-policy change patients spent fewer days on the waitlist (15 versus 35 days, P<0.001), had longer ischemic times (3.5 versus 3.0 hours, P<0.001), and received organs from a greater distance (301 versus 105 miles, P<0.001). By multivariable analysis, days on the waitlist (for every 30 days; odds ratio, 1.01 [95% CI, 1.00-1.02], P=0.031) and diabetes mellitus (odds ratio, 1.87 [95% CI, 1.16-3.02], P=0.011) emerged as significant predictors of post-transplant mortality. After the policy change, waitlisted patients requiring IABP support were more likely to survive to transplant (76.4 versus 89.8%, P<0.001).ConclusionsIABP utilization has increased over 3-fold since the 2018 policy change with improved waitlist outcomes and comparable post-OHT survival. Thus, bridging patients to OHT with IABPs appears to be an effective strategy in the current era.

| S-EPMC9057452 | biostudies-literature

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