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Case Report

Entrapment of a large air bubble at aortic root associated with intra-aortic balloon pump insertion

Hana Kim1, Sang-Ik Baek2, Hack-Lyoung Kim1

1MD, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

Article ID: 100001VAM02HK2017
doi:10.5348/VAM02-2017-1-CR-1

Address correspondence to:

Hack-Lyoung Kim
MD., PhD, Division of Cardiology, Department of Internal Medicine, Boramae Medical Center
Seoul National University College of Medicine, 20 Boramae-ro 5-gil
Dongjak-gu, Seoul 07061
Korea


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How to cite this article
Kim H, Sang-Ik B, Hack-Lyoung K. Entrapment of a large air bubble at aortic root associated with intra-aortic balloon pump insertion. Video J Cardiol 2017;1:1–5.

Abstract

Introduction: Intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenation (ECMO) are commonly used devices in patients presenting with cardiogenic shock complicated by acute myocardial infarction. The common complications related with these devices are bleeding and thrombosis. On the other hand, air embolism is a very rare complication, especially related to IABP insertion. There has been lack of data on air embolism related to IABP without balloon rupture.

Case Report: A 59-year-old male with acute myocardial infarction and cardiogenic shock underwent emergent percutaneous coronary intervention (PCI) on ECMO support. After PCI, IABP was inserted via left femoral vein. Immediately after IABP insertion, large air bubble with oscillating motion was found in aortic root. The air bubble was so large that could fill-up almost all part of aortic root. The air bubble was trapped in aortic root and did not move to aortic arch or left ventricle. The air bubble was successfully aspirated using coronary catheter.

Conclusion: More careful attention should be given during the IABP insertion to prevent air embolism, especially when there is reverse flow in the aorta by ECMO.

Keywords: Acute myocardial infarction, Air embolism, Cardiogenic shock, Extracorporeal membrane oxygenation, Intra-aortic balloon pump

Author Contributions

Hana Kim – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sang-Ik Baek – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Hack-Lyoung Kim – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of submission
The corresponding author is the guarantor of submission.

Source of support
None

Conflict of interest
Authors declare no conflict of interest.

Copyright
©2017 Hana Kim et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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