IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Liver and Renal Failure due to Thrombus arising from Intraaortic Balloon Pump
Nawid Khaladj, MD,
Thomas Rodt, MD1,
Sven Peterss, MD,
Christian Hagl, MD,
Axel Haverich, MD,
Malakh Shrestha, MD
Department for Cardiac, Thoracic, Transplantation and Vascular Surgery
1 Division of Radiology, Hannover Medical School, Hannover, Germany
Nawid Khaladj, MD Tel: +49 511 532 6581 Fax: +49 511 532 5404 Email: Khaladj.Nawid{at}mh-hannover.de, Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
A 60-year-old man underwent rescue coronary artery bypass grafting for acute ST-segment elevation myocardial infarction (plasma creatine kinase> 10,000 U·L–1) in cardiogenic shock. An intraaortic balloon pump was inserted during reperfusion intraoperatively. The patient developed elevated serum liver enzymes and lactate levels, and acute renal failure postoperatively. A computed tomography scan revealed a thrombus below the balloon of the intraaortic balloon pump, with partial occlusions of the truncus coeliacus, arteria mesenterica superior, and both renal arteries, despite therapeutic anticoagulation with intravenous heparin (Figure 1
). The patient died subsequently due to multiple organ failure.
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Figure 1. Thrombus formation arising from an intraaortic balloon pump, with partial occlusion of the visceral (A) and renal arteries (B).
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Asian Cardiovasc Thorac Ann 2010;
18:91
© 2010 by SAGE Publications
DOI: 10.1177/0218492309355208
