Elective peri-operative intra-aortic balloon counterpulsation during maxillofacial free flap reconstructive surgery in a patient with severe cardiomyopathy.

A key anaesthetic goal in reconstructive free flap surgery is to maintain optimum blood flow to maximise flap survival. We describe the use of intra-aortic balloon counterpulsation in a patient with severe cardiac dysfunction, in whom surgery was initially felt to be contraindicated.