Six years' experience with closed-chest decannulation of transthoracically inserted cardiac-assist balloon catheters.

The efficiency and risks of a method that allows closed-chest decannulation of an intraoperatively inserted cardiac-assist balloon catheter are examined. The technique involves direct insertion of the balloon catheter into the ascending aorta under the protection of an indwelling silastic tourniquet. At the discretion of the surgeon, the tourniquet may be left in place or removed later through a small infrasternal incision. This method was applied for 6 years, from May 1985 to June 1991, in 18 patients. Satisfactory cardiac assistance was achieved in every patient, and no early or late complications or deaths were attributable to the technique. At the time of this report, 9 patients are still alive. The author recommends the application of the procedure whenever, in the course of open-heart operations, cardiac-assist intraaortic balloon pulsation becomes necessary and conventional transfemoral insertion is either impossible or inadvisable.