THE USE OF INTRAAORTIC BALLOON PUMP AFTER SURGICAL-TREATMENT OF DEBAKEY TYPE-I DISSECTING ANEURYSM OF THE AORTA

The case is reported of a sixty-four-year-old patient with DeBakey typ e I aortic dissection in whom postoperative extensive intra-aortic bal loon pumping was applied. Surgical repair involved replacing the ascen ding aorta with a Medtronic Hall valved conduit. After surgery severe low-output syndrome occurred. Despite the use of high-dose inotropic d rugs the patient could not be hemodynamically stabilized. An intra-aor tic balloon pump was finally applied as a therapeutical last resort. W ithin three days, under counterpulsation, the patient reached a stable hemodynamic condition. After twenty-one days in the intensive care un it, he could be transferred to a normal ward. The patient was discharg ed on the fifty-fourth postoperative day. During counterpulsation ther e were no balloon- or catheter-induced complications. Follow-up at fiv e months showed the patient in good general health: echocardiography d id not identify any lesions of the thoracic aorta which could be linke d to counter-pulsation. It is concluded that the postoperative use of intra-aortic balloon pump in the event of DeBakey type I dissecting an eurysm of the aorta, and adversely affected patient hemodynamics, is a justifiable therapeutical alternative.