| Japanese |
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| Title | IABP抜去困難に対し低侵襲手術にて抜去し得た一例 |
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| Subtitle | 症例 |
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| Authors | 垣伸明, 齋藤政仁, 今関隆雄, 入江嘉仁, 木山宏, 村井則之, 佐藤康広, 秦一剋, 権重好, 汐口壮一, 千葉知史, 岡田修一, 長磨美子, 田中恒有 |
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| Authors(kana) | |
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| Organization | 獨協医科大学越谷病院心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 24 |
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| Number | 3 |
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| Page | 253-256 |
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| Year/Month | 2003/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「諸言」Intra aortic balloon pumping(IABP)のバルーン損傷は, 稀な合併症であるが, バルーン内の血栓形成により抜去困難となると, 緊急の外科的抜去術が必要となる. 著者らは, 腹部血管の低侵襲手術を用い, 抜去し得た症例を経験したので報告する. 「症例」症例：75歳, 男性 既往歴：75歳時に慢性腎不全 経過：不安定狭心症の診断で, 平成14年9月25日IABP挿入下に冠動脈バイパス手術を施行した. 術前から陳旧性心筋梗塞による低左室機能があったため, 術後長期IABP管理が必要となった. IABP駆動7日目に突然IABPのヘリウムガスリークアラームが頻回に鳴り, カテーテル内に血液を認めたため, バルーン損傷を疑い即座に停止させた. バルーン内の凝血塊形成に伴う抜去困難を危惧し右大腿動脈より抜去を試みた. 大動脈分岐部付近までは抜けたが, 同部位に嵌頓固定されており抜去できなかった(図1). 急性下肢動脈閉塞への発展を恐れバルーンの位置を大動脈内に戻し, 緊急で外科的抜去手術とした. 手術：全身麻酔下に皮切長が10cmの小切開低侵襲手術とした(図2). 右傍腹直筋切開, 後腹膜経路によりアプローチした. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Intra-aortic balloon pump, Intra-aortic balloon entrapment, Rupture, Complication |
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| English |
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| Title | Minimal Invasive Technique with Abdominal small Incision for Intra Aortic Balloon Entrapment：A case report. |
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| Authors | Nobuaki Kaki, Masahito Saitho, Takao Imazeki, Kihito Irie, Hiroshi Kiyama, Noriyuki Murai, Yasuhiro Satho, Ikkoku Hata, Shigeyoshi Gon, Souichi Shioguchi, Tomofumi Thiba, Syuuichi Okada, Mamiko Chou, Kouyuu Tanaka |
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| Authors(kana) | |
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| Organization | Department of Cardiovascular and Thoracic Surgery, Dokkyo University School of Medicine Koshigaya Hospital |
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| Journal | Circulation Control |
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| Volume | 24 |
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| Number | 3 |
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| Page | 253-256 |
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| Year/Month | 2003/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 75-year-old man with unstable angina pectoris underwent coronary artery bypass grafting. Femoral IABP insertion was accomplished preoperatively, because of low left ventricular function. On the seventh postoperative day the IABP balloon rupture was detected. An attempt was made to remove the balloon at the bedside, but balloon entrapment was occurred. Surgical treatment was required for removing the balloon. In order to reduce operative invasion, the abdominal aorta and iliac artery were exposed through a small flank incision with retroperitoneum approach. The device was easily removed through a common iliac artery incision. Balloon rupture is a comparatively rare complication, but if occurs, the blood clot formation inside the balloon will result in balloon entrapment in the vessel frequently. Generally the case who needs the IABP as a mechanical assistance has a critical heart failure. Further the invasive laparotomy or large flank incision may worsen the hemodynamicss tatus. Accordingly the minimal invasive technique was very important to reduce a patient's burden. |
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| Practice | Basic medicine |
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| Keywords | Intra-aortic balloon pump, Intra-aortic balloon entrapment, Rupture, Complication |
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