Anesthetic Management of Intra-aortic Balloon Pump-Induced Systolic Anterior Motion of the Mitral Valve During Coronary Artery Bypass Grafting.

Division

East Florida

Hospital

Westside Regional Medical Center

Document Type

Case Report

Publication Date

3-24-2024

Keywords

cardiothoracic anesthesia, coronary artery bypass graft (cabg), hypertrophic obstructive cardiomyopathy (hocm), intra-aortic balloon pump (iabp), left ventricular outflow tract obstruction (lvoto), perioperative tee, systolic anterior motion of mitral valve

Disciplines

Anesthesiology | Cardiovascular Diseases | Medicine and Health Sciences

Abstract

The intra-aortic balloon pump (IABP) is a mechanical device that increases myocardial oxygen perfusion and indirectly increases cardiac output through afterload reduction. Since its inception, the IABP has been a mainstay of cardiac support devices, utilized as a temporizing measure in patients with or prone to developing cardiogenic shock that are awaiting definitive treatment. Systolic anterior motion (SAM) of the mitral valve is a well-described phenomenon that can precipitate hemodynamic collapse by obstructing the left ventricular outflow tract in a subset of patients with cardiac pathology, most notably hypertrophic obstructive cardiomyopathy (HOCM). This report describes the case and anesthetic management of a patient who had an IABP placed for support and later developed SAM and hemodynamic compromise after induction of general anesthesia during a coronary artery bypass surgery.

Publisher or Conference

Cureus

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