Intra-aortic balloon pump counterpulsation in the management of concomitant cerebral vasospasm and cardiac failure after subarachnoid hemorrhage: technical case report. Neurosurgery 1996 May;38(5):1056-9; discussion 1059-60
Date
05/01/1996Pubmed ID
8727836DOI
10.1097/00006123-199605000-00042Scopus ID
2-s2.0-0029868366 (requires institutional sign-in at Scopus site) 60 CitationsAbstract
We report two patients who had symptomatic cerebral vasospasm and cardiac failure after aneurysmal subarachnoid hemorrhage and who were treated successfully with intra-aortic balloon pump counterpulsation therapy. Both patients developed congestive heart failure and pulmonary edema while receiving postoperative hypertensive, hypervolemic, hemodilutional (Triple-H) therapy for symptomatic cerebral vasospasm. Both cases of cardiac failure were refractory to maximum pressor and inotropic infusions. Intra-aortic balloon pump counterpulsation was used to optimize cardiac performance to allow continuation of Triple-H therapy and to maintain adequate cerebral perfusion in an attempt to decrease the risk of cerebral ischemic complications. Both patients have had good long-term outcomes. These two cases illustrate the potential usefulness of the intra-aortic balloon pump as an adjunct to Triple-H therapy in patients with symptomatic cerebral vasospasm and cardiac failure. To our knowledge, this report documents the first clinical application of this adjunctive therapy for vasospasm after aneurysmal subarachnoid hemorrhage.
Author List
Apostolides PJ, Greene KA, Zabramski JM, Fitzgerald JW, Spetzler RFAuthor
Karl A. Greene MD Adjunct Assistant Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAneurysm, Ruptured
Combined Modality Therapy
Female
Heart Failure
Hemodynamics
Humans
Intra-Aortic Balloon Pumping
Intracranial Aneurysm
Ischemic Attack, Transient
Middle Aged
Postoperative Complications
Subarachnoid Hemorrhage
