33968 Removal of intra-aortic balloon assist device, percutaneous

Name of the Procedure:

Removal of intra-aortic balloon assist device (IABP), percutaneous

Summary

The removal of an intra-aortic balloon pump (IABP) involves taking out a catheter-based device that was inserted into the aorta to help the heart pump more effectively. This procedure is done percutaneously, meaning it is performed through the skin, using minimally invasive techniques.

Purpose

The IABP is used to provide temporary support to the heart in cases of severe cardiac issues such as heart failure or after significant cardiac surgery. The removal procedure is needed once the patient’s heart function has improved, and the device is no longer necessary.

Indications

• Improvement in cardiac function
• Resolution of the acute condition that warranted IABP insertion
• Adequately stable cardiovascular status that no longer requires mechanical support

Preparation

• Patients may need to fast for a few hours before the procedure.
• Regular medications should be taken unless instructed otherwise.
• Blood tests or imaging studies might be needed to assess health status.

Procedure Description

1. The procedure is usually performed in a hospital setting such as a cardiac catheterization lab.
2. The patient is positioned appropriately and the insertion site (usually the groin) is sterilized.
3. Local anesthesia is applied to numb the area.
4. The percutaneous sheath is carefully removed along with the balloon catheter.
5. The physician applies pressure to the site to achieve hemostasis and then places a sterile dressing on the area.

Duration

The removal procedure typically takes 30 minutes to 1 hour.

Setting

The procedure is performed in a hospital, often in the cardiac catheterization lab or a specialized procedural room.

Personnel

• Interventional cardiologist or vascular surgeon
• Assisting nurses
• Anesthesiologist or nurse anesthetist (if sedation is required)
• Technicians for equipment management

Risks and Complications

• Infection at the insertion site
• Bleeding or hematoma formation
• Vascular injury
• Embolization (blood clot dislodgement)
• Rarely, cardiac or arterial complications requiring further intervention

Benefits

• Removal of the IABP allows the patient to regain mobility and decreases the risk of long-term complications associated with prolonged use of the device.
• Once removed, patients often feel more comfortable and can start other rehabilitative therapies.

Recovery

• Post-removal, patients are monitored in a recovery room for several hours to ensure there is no bleeding or complications.
• Instructions will include keeping the limb (usually the leg) straight and avoiding strenuous activities for a few days.
• Follow-up appointments are scheduled to ensure proper healing and to monitor heart function.

Alternatives

• If removal is not advisable, continued monitoring with adjustments to medical therapy may be considered.
• Other mechanical support devices, like ventricular assist devices (VADs), may be an alternative for long-term support.

Patient Experience

During the procedure, the patient will receive local anesthesia to minimize discomfort. Some pressure or pulling sensations may be felt but pain should be minimal. Post-procedure, there may be some soreness or bruising at the removal site. Pain management strategies, including medications and wound care, will be provided to ensure comfort.

This markdown text provides a comprehensive overview of the removal of an intra-aortic balloon assist device via a percutaneous approach, including procedural details, preparation, and patient care information.