Partial Right Atrial Inflow Occlusion for Transient Systemic Hypotension During Deployment of Thoracic Stentgrafts

CardioVascular and Interventional Radiology, vol. 44, pp. 1116–1120

Abstract

PURPOSE: Temporary balloon occlusion of the inferior vena cava to lower cardiac output is a relatively infrequently used technique to induce controlled systemic hypotension. In this technical note, we describe the feasibility, reliability, and safety of partial occlusion of right atrial inflow and the effect on systemic blood pressure during the deployment of a thoracic stentgraft. MATERIALS AND METHODS: Twenty consecutive patients undergoing thoracic endovascular aortic repair, with proximal landing in zone 0-3 of the thoracic aorta, were prospectively included. Right atrial inflow occlusion was performed with a compliant occlusion balloon. RESULTS: Median time to reach a mean arterial pressure of 50 mmHg was 43 s. Median recovery time of blood pressure was 42 s. CONCLUSION: Partial right atrial inflow occlusion with an occlusion balloon is feasible with reliable results and without procedure-related complications.

Authors 6

1. Lars Cornelis Pietersen corresponding Aachen Department of Interventional Radiology

   Leiden University Medical Center

   Affiliation as printed

   Department of Interventional Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. L.C.Pietersen@lumc.nl

   Department of Interventional Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

2. Rutger W. van der Meer Aachen Department of Interventional Radiology

   Leiden University Medical Center

   Affiliation as printed

   Department of Interventional Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

3. David J. C. Alders Aachen Department of Anesthesiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands

4. Jan van Schaik Aachen Department of Vascular Surgery

   Leiden University Medical Center

   Affiliation as printed

   Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands

5. Daniël Eefting Aachen Department of Vascular Surgery

   Leiden University Medical Center

   Affiliation as printed

   Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands

6. Catherina S. P. van Rijswijk Aachen Department of Interventional Radiology

   Leiden University Medical Center

   Affiliation as printed

   Department of Interventional Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands