Intraaortic Balloon Counterpulsation Improves Right Ventricular Failure Resulting From Pressure Overload

Right Ventricular Failure Resulting from Pressure Overload: Role of Intra-Aortic Balloon Counterpulsation and Vasopressor Therapy

“…However, IABP failed to substantially elevate mean AP, and RV-LV interactions were not improved since biventricular size, function, TR, or septal bulging remained unchanged. Previous reports contradict our results and have demonstrated a positive effect of IABP on RV and cardiocirculatory function during RVPO [19,20]. However, only a few patients with RV failure and various inotropic support were investigated [19], and beneficial actions of IABP to RV function could not be clearly related to improved RV-LV interactions or RV perfusion in these studies [20], making the interpretation of these observations difficult.…”

“…Previous reports contradict our results and have demonstrated a positive effect of IABP on RV and cardiocirculatory function during RVPO [19,20]. However, only a few patients with RV failure and various inotropic support were investigated [19], and beneficial actions of IABP to RV function could not be clearly related to improved RV-LV interactions or RV perfusion in these studies [20], making the interpretation of these observations difficult. Our results imply that the moderate enhancement of CDP with IABP was insufficient to substantially restore RV hypoperfusion since higher systemic perfusion pressures might be necessary to allow sufficient coronary flow to the RV, as coronary autoregulation fails and flow is increasingly pressure-dependent in the oxygen demanding, afterloaded RV [8,10,11,31].…”

“…We, like others [5,10,20], selected an acute animal model with fixed pulmonary artery constriction to exclude spontaneous changes of pulmonary artery obstruction.…”

“…In this context, intra-aortic balloon counterpulsation (IABP) seems to be a promising addition to systemic vasopressors as it unloads the LV and augments systemic and coronary driving pressure [17,18]. Supportive data for a stand-alone IABP therapy during RVPO arises from two reports [19,20] that could demonstrate beneficial effects on cardiac output, but failed to clearly identify the underlying causes of their findings.…”

Right side of heart failure

“…Over a decade ago, mechanical therapies were being studied to improve RV failure. Intra-aortic balloon pumps improved RV function in sheep where RV failure was induced by increasing RV afterload [113]. Intra-aortic balloon counterpulsation in low output syndromes due to RV failure resulted in increased cardiac output and decreased wedge pressure [114][115][116].…”