A 56-year-old man suffered severe gastrointestinal tract bleeding five days following an anterior myocardial infarction. Nonoperative treatment consisting of gastric lavage, selective angiographic procedures on the gastric arteries with intra-arterial vasopressin injection (Pitressin), and massive blood replacement over a five-day period failed to halt hemorrhage. Institution of intra-aortic balloon pumping reversed the patient's hemodynamic deterioration and made possible a definitive operation. The successful outcome in this patient suggests that counterpulsation may play a useful role in lowering the formidable surgical mortality observed in patients with acute myocardial injury who require emergency noncardiac operations.
Cohen SI, Weintraub RM. A New Application of Counterpulsation: Safer Laparotomy After Recent Myocardial Infarction. Arch Surg. 1975;110(1):116–117. doi:10.1001/archsurg.1975.01360070116020
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