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Eur J Cardiothorac Surg 2004;26:830
© 2004 Elsevier Science NL

Images in cardio-thoracic surgery

Imminent dislodgement of atheromatous aortic plaque during insertion of a balloon catheter prevented by transoesophageal echocardiography

Christos Alexioua*, Justiaan Swanevelderb, George Doukasa, Tom J. Spyta

a Department of Cardiac Surgery, Glenfield General Hospital, Groby Rd, Leicester LE3 9QP, UK
b Department of Cardiac Anaesthesia, Glenfield Hospital, Leicester, UK

Received 13 April 2004; accepted 18 May 2004.

* Corresponding author. Tel.: +44-116-2871471; fax: +44-116-2321282
e-mail: alexiou486{at}aol.com

Key Words: CABG • Balloon catheter • Transoesophageal echocardiography

A 63-year-old male required insertion of an intra-aortic balloon catheter following CABG. Attempts to advance the catheter were met with mild resistance. Transoesophageal echocardiography showed a large atheromatous aortic plaque (Fig. 1) , raised by the catheter (Fig. 2) . In order to avoid dislodgement of the aortic plaque, the procedure was terminated.



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  		Fig. 1. Transoesophageal echocardiogram showing the tip of the balloon catheter approaching a large atheromatous plaque within the descending aorta.

 


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  		Fig. 2. Transoesophageal echocardiogram showing the advanced tip of the balloon catheter raising the atheromatous plaque from the aortic wall.

 




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