Intra-aortic Balloon Counterpulsation-Assisted Cardiac Support in the Anesthetic Management of Surgery for Acute Cervical Spine Compression With Severe Coronary Artery Disease in the Prone Position

Severe coronary artery disease associated with the requirement for urgent cervical spine surgery in an elderly patient in a prone position is challenging for the anesthesiologist.Perioperative hemodynamic parameters are key to surgical success.Intra-aortic balloon counterpulsation (IABC) is a well-established modality for the management of patients with ischemic heart disease.There are very few case reports on management in noncardiac surgery with IABC.Here, we present a case report of a 74-year-old male patient with cervical cord compression scheduled for C3-C7 laminectomy and lateral mass fixation, with severe coronary artery disease and a recent history of severe coronary artery disease with triple-vessel disease and severely impaired left ventricular function, managed with IABC insertion post-induction of general anesthesia for intraoperative hemodynamic management to prevent cervical cord hypoperfusion and perioperative myocardial ischemia/infarction.