Intra-aortic balloon pump
The Intra-aortic balloon pump (IABP) is a mechanical device that increases myocardial oxygen perfusion while at the same time increasing Cardiac output. It consists of a cylindrical polyethylene balloon that sits in the aorta and counterpulsates. That is, it actively deflates in systole, increasing forward blood flow by reducing afterload through a vacuum effect. It actively inflates in diastole, increasing blood flow to the coronary arteries via retrograde flow.
- Reversible intracardial mechanical defects complicating infarction, i.e. acute mitral regurgitation and septal perforation.
- Unstable angina pectoris benefits from counterpulsation.
- Post Cardiothoracic surgery - most common and useful is counterpulsation in weaning patients from cardiopulmonary bypass after continued perioperative injury to myocardial tissue.
- Preoperative use is suggested for high-risk patients such as those with unstable angina with stenosis greater than 70% of main coronary artery, in ventricular dysfunction with an ejection fraction less than 35%.
- Percutaneous coronary Angioplasty.
- In high risk coronary artery bypass graft surgery where cardiopulmonary bypass time was shortened, as well as during intubation period and hospital stay.
- Thrombolytic therapy of acute myocardial infarction.