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1/9. Vasopressin effective in reversing catecholamine-resistant vasodilatory shock.

    A patient with perforated appendicitis developed progressive vasodilatory shock which was complicated by perioperative acute myocardial infarction. Cardiovascular support included dopamine infusion, and later, intra-aortic balloon counterpulsation balloon pump and noradrenaline and dobutamine infusion. Vasopressin was introduced as a final attempt to reverse the refractory shock and was associated with recovery. The experience with this case suggests that vasopressin may be a valuable adjunct to the treatment of catecholamine-resistant vasodilatory shock.
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ranking = 1
keywords = counterpulsation
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2/9. Intracoronary thrombolysis and intraaortic balloon counterpulsation for the emergency treatment of probable coronary embolism after repair of an acute ascending aortic dissection.

    IMPLICATIONS: This report shows that if diffuse coronary thromboembolism is encountered during ascending aortic dissection-repair, the option of combining single-bolus, intracoronary thrombolysis with intraaortic balloon counterpulsation should be considered.
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ranking = 5
keywords = counterpulsation
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3/9. Vascular complications of the intra-aortic balloon counterpulsation.

    From September 1994 to December 2002, 6,274 cardiosurgery operations were performed at the Department of Cardiac Surgery, University Hospital, Hradec Kralove, czech republic. Intra-aortic balloon counterpulsation (IABP) was applied in 192 cases (3.1%). From this group of 192 counterpulsated patients 103 were successfully treated (53.6%); 89 counterpulsated patients (46.4%) died from the surgical procedure (30-day mortality rate). In 5 cases (2.6%) from the group of 192, the IABP was introduced before the operation. Ischemic changes of the limb were observed in 11 cases (5.7%). Significant bleeding occurred at the site of puncture in 6 cases (3.1%). dissection of the femoral and iliac arteries was found in 2 patients (1.0%), perforation of the iliac artery in 1 case (0.5%). In 2 cases (1.0%) the balloon was led into the venous system. In case report No. 1 an introduction of the balloon under a sclerotic plaque of the descending aorta and iliac artery is described. In case report No. 2 a placement of the balloon in the venous bloodstream is reported.
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ranking = 5
keywords = counterpulsation
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4/9. Effect of intra-aortic balloon counterpulsation on right-left shunt following right ventricular infarction.

    Intra-aortic balloon counterpulsations decrease the left ventricular end-diastolic pressure and, subsequently, the left atrial pressure in patients with impaired myocardial function following myocardial infarction. This paper reports a case of right ventricular infarction in a patient with patency of the oval foramen where the use of intra-aortic balloon counterpulsation led to the perpetuation of the right-to-left shunt.
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ranking = 6
keywords = counterpulsation
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5/9. pulmonary artery balloon counterpulsation for intraoperative right ventricular failure.

    Two cases of severe low cardiac output and right ventricular failure after coronary artery bypass grafting necessitated pulmonary artery balloon counterpulsation after intraaortic balloon pumping and maximal inotropic/pressor support were unsuccessful in maintaining a satisfactory cardiac output. Hemodynamic improvement was sufficient to allow removal of the device 2 and 3 days postoperatively, with survival in 1 patient. pulmonary artery counterpulsation is less morbid in comparison with other mechanical methods of right ventricular support and is applicable in right ventricular failure of intermediate severity.
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ranking = 6
keywords = counterpulsation
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6/9. Intra-aortic balloon counterpulsation in high-risk cardiac patients undergoing noncardiac surgery.

    patients undergoing noncardiac general surgical procedures after coronary artery bypass surgery have reduced mortality compared with those operated on without prior revascularization. The urgency of the noncardiac procedure and the potential reconstructability of the coronary artery anatomy may mitigate against timely revascularization. We report the successful outcome of prophylactic intra-aortic balloon counterpulsation in three patients with coronary artery disease and impaired left ventricular function undergoing noncardiac surgical procedures. Intra-aortic balloon counterpulsation may provide myocardial protection in high-risk cardiac patients requiring noncardiac surgery initially. A review of the literature is discussed.
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ranking = 6
keywords = counterpulsation
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7/9. pulmonary artery balloon counterpulsation for treatment of intraoperative right ventricular failure.

    pulmonary artery balloon counterpulsation was used in 3 patients who underwent open-heart operation for the treatment of acquired cardiac lesions. This form of support was initiated because the patients could not be weaned from cardiopulmonary bypass even with intraaortic balloon counterpulsation and maximal pharmacological support. After pulmonary artery balloon pumping was instituted, cardiopulmonary bypass was successfully terminated in all 3 patients. One of them is alive and well one year after operation.
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ranking = 6
keywords = counterpulsation
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8/9. Successful balloon counterpulsation for right ventricular failure.

    We used pulmonary arterial balloon counterpulsation to treat successfully a patient with severe right ventricular failure following mitral valve replacement. The balloon was placed through a vascular graft sutured as a diverticulum to the main pulmonary artery.
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ranking = 5
keywords = counterpulsation
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9/9. Management of intraoperative right ventricular failure with pulmonary artery balloon counterpulsation.

    There are many etiologic factors that contribute to the development of right ventricular failure. However, the clinical manifestations and treatment modalities parallel whether the causative factor is from intraoperative complications or cardiovascular pathology. When adequate preload and pharmacologic support fail to enhance right ventricular function, the placement of a pulmonary artery balloon catheter for counterpulsation may be required. Currently, the pulmonary artery balloon catheter requires intraoperative placement. However, further research and refinements may allow peripheral placement of the catheter, using a smaller sized balloon. A case study is presented of a patient requiring intraaortic and pulmonary artery balloon counterpulsation for intraoperative right ventricular failure, after a mitral valve replacement.
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ranking = 6
keywords = counterpulsation
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