Malpositioned intra-aortic balloon pump - too low

Case contributed by Assoc Prof Craig Hacking

Presentation

Post mitral valve repair.

Patient Data

Age: 60 years
Gender: Female

Sternal wires and mitral ring noted. The ETT, NGT, right pleural catheter, mediastinal drain and pericardial drain are well positioned. The tip of the intra-aortic balloon pump (IABP) is below the level of the left main bronchus which is too low.

Diffuse airspace opacities and left lower lobe collapse are stable compared to the most recent CXR.

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 low.

Case courtesy of Dr Nivene Saad.

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