Eur J Cardiothorac Surg 1999;16:663-664
© 1999 Elsevier Science NL
Images in cardio-thoracic surgery |
Fatal ischemic multiorgan damage with intraaortic balloon pumping in a patient with small aorta syndrome
Paul R. Vogt,
Gregor Zünd,
Marko I. Turina
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland
Corresponding author. Tel.: +41-1-255-1111; fax: +41-1-255-4446
e-mail: paul.vogt{at}chi.usz.ch
Key Words: Intraaortic balloon pump • Small aorta syndrome
The small aorta syndrome (SAS) is described in females with occlusive aorto-iliac disease. This 56-year-old male patient, being 172 cm tall and weighing 75 kg, died from bowel necrosis, liver and kidney failure occurring 12 h after intraaortic balloon pump (IABP) insertion. The IABP of 26.3 mm length (Fig. 1), reaching below the renal arteries, dramatically limited diastolic blood flow in the abdominal aorta (Fig. 2). Angiography and postmortem analysis revealed several features corresponding to SAS: an infrarenal aortic diameter of 13.4 mm (SAS 13.2 mm); an aortic bifurcation of 10.0 mm (<10.2 mm), an aortic bifurcation angle of 30° (<30°) and an iliac artery diameter of 5 mm (<7 mm). The transverse arch diameter of 20 mm (mean age-related diameter 2.26 mm) and the descending aortic diameter of 18 mm (1.9 mm) contributed to this dramatic situation associated with placement of an IABP in an unrecognised small aorta.
Received July 27, 1999;
received in revised form September 13, 1999;
accepted September 28, 1999.
