Malpositioned intra-aortic balloon pump - too high

Case contributed by Craig Hacking


Day 0 post tissue AVR and arch replacement.

Patient Data

Age: 45 years
Gender: Male

Sternal wires and aortic valve replacement noted. The ETT, NGT, two right jugular CVLs and two mediastinal drains are well positioned. The tip of the intra-aortic balloon pump (IABP) is projected within the aortic arch which is too high.

Left lower zone opacification obscuring the elevated left hemidiaphragm is in keeping with post operative left lower lobe collapse. 

Case Discussion

The IABP radio-opaque tip should be in the upper aspect of the descending aorta, just distal to the left subclavian artery origin. On CXR it should be at the level of the AP window. In this case it is too high.

Case courtesy of Dr Nivene Saad.

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