Intraaortic Balloon Pump

The intra-aortic balloon pump (IABP) is inserted via the femoral artery and lies within the descending thoracic aorta. It increases coronary perfusion by inflating during diastole and decreases afterload against which the heart must eject by deflating just before systole. It is by these two mechanisms that the IABP improves cardiac performance. It is most often used intraoperatively to support a failing ventricle (i.e. a ventricle that will not come off cardiopulmonary bypass). Other important indications include: 1) intractable angina pectoris; 2) cardiogenic shock or low output state outside of the operating room; 3) mitral regurgitation or acute ventricular septal defect secondary to infarctions; and 4) uncontrolled malignant arrhythmias.

Contraindications to an IABP include severe aorto-iliac disease that preclude entering the femoral artery. If an IABP is absolutely required despite this contraindication, it may be necessary to place the balloon into the ascending aorta and thread it into the descending thoracic aorta. Other contraindications include aortic insufficiency which would worsen with inflation of the balloon. Another contraindication is aortic dissection because of possible injury to the aorta by the balloon, although it has succeeded in selected instances.

Your Heart and Nutrition

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