Usefulness of Intra-aortic Balloon Pump Counterpulsation

Nunen, Lokien X. van; Noč, Marko; Kapur, Navin K.; Patel, Manesh R.; Perera, Divaka; Pijls, Nico H.J.

doi:10.1016/j.amjcard.2015.10.063

Cited by 49 publications

(18 citation statements)

References 40 publications

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“…During systole, rapid deflation of the intra-aortic balloon generates a pressure sink, which reduces LV afterload and increases LV cardiac output 13 . The magnitude of hemodynamic support generated by an IABP is directly related to LV cardiac output.…”

Section: Solving the Hemodynamic Support Equation With Acute Mechanicmentioning

confidence: 99%

Acute mechanical circulatory support for cardiogenic shock: the “door to support” time

Esposito

Kapur

2017

F1000Res

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Cardiogenic shock (CS) remains a major cause of in-hospital mortality in the setting of acute myocardial infarction. CS begins as a hemodynamic problem with impaired cardiac output leading to reduced systemic perfusion, increased residual volume within the left and right ventricles, and increased cardiac filling pressures. A critical step towards the development of future algorithms is a clear understanding of the treatment objectives for CS. In this review, we introduce the “door to support” time as an emerging target of therapy to improve outcomes associated with CS, define four key treatment objectives in the management of CS, discuss the importance of early hemodynamic assessment and appropriate selection of acute mechanical circulatory support (AMCS) devices for CS, and introduce a classification scheme that identifies subtypes of CS based on cardiac filling pressures.

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Section: Solving the Hemodynamic Support Equation With Acute Mechanicmentioning

confidence: 99%

Acute mechanical circulatory support for cardiogenic shock: the “door to support” time

Esposito

Kapur

2017

F1000Res

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“…Since its introduction by Moulopoulos et al. in 1962, the IABP has been the most widely used circulatory assist device in critically ill patients with cardiac disease (Moulopoulos, Topaz, & Kolff, ; van Nunen et al., ). Its wide use, however, has been harshly questioned over the last few years, especially by the Shock II trial (Thiele et al., ).…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric and renal flow patterns during intra‐aortic counterpulsation

Johnson

Lozekoot

Jong

et al. 2019

Experimental Physiology

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New Findings What is the central question of this study?Visceral ischaemia is one of the most feared complications during use of an intra‐aortic balloon pump. Using an animal model, we measured the flows at the abdominal level directly and examined flow patterns to enable investigation of flow patterns during the use of the intra‐aortic balloon pump. What is the main finding and its importance?We show that there is a significant balloon‐related reduction in superior mesenteric flow in both early and mid‐diastole. Abstract A number of previous studies have shown that blood flow in the visceral arteries is altered during intra‐aortic balloon pump (IABP) treatment. We used a porcine model to analyse the pattern of blood flow into the visceral arteries during IABP use. For this purpose, we measured the superior mesenteric, right renal and left renal flows before and during IABP support, using surgically placed flowmeters surrounding these visceral arteries. The superior mesenteric flow significantly decreased in early diastole (P < 0.001) and in mid‐diastole (P = 0.003 versus early diastole), whereas in late diastole it increased again (P < 0.001 versus mid‐diastole). During systole, the flow was not significantly increased compared with late diastole (P = 0.51), but it was significantly lower than at baseline (both P < 0.001). Flows did not differ between right and left kidneys. Perfusion of either kidney did not change significantly in early diastole (P > 0.05), whereas it decreased significantly in mid‐diastole (P < 0.001), rising dramatically in late diastole (P < 0.001) and with an additional slight increase in systole (P = 0.054). This study provides important insights into abdominal flows during intra‐aortic pump counterpulsation. Furthermore, it supports the need to rethink the balloon design to avoid visceral ischaemia during circulatory assistance.

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“…In both patients we used IACPB which is not recommended in current guidelines for treating STEMI patients, yet use of IACPB was a standard practice in STEMI patients with low blood pressure prior to introduction of reperfusion therapies. Although two controlled studies showed no survival benefits of IACPB in STEMI patients, the use of IACPB in the above reported patients contributed to survival of these patients that were presented with low blood pressure and cardiogenic shock [9]. Radial approach is currently the most used approach for coronary catheterization and is associated with fewer complications [10].…”

Section: Discussionmentioning

confidence: 99%

Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion

Flugelman

Ben–Dov

Karkabi

et al. 2016

Case Reports in Cardiology

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Acute occlusion of left main coronary artery is a catastrophic event. We describe two patients with acute occlusion of the left main coronary artery treated thirty years apart. The first patient was treated in 1982 and survived the event without revascularization but developed severe heart failure. His survival was so unusual that it merited a case report at that time. The second patient was treated at the end of 2015. Early revascularization resulted in myocardial reperfusion and near normal left ventricular function. These patients exemplify the progress in therapeutic cardiology over the last 30 years.

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Usefulness of Intra-aortic Balloon Pump Counterpulsation

Cited by 49 publications

References 40 publications

Acute mechanical circulatory support for cardiogenic shock: the “door to support” time

Acute mechanical circulatory support for cardiogenic shock: the “door to support” time

Superior mesenteric and renal flow patterns during intra‐aortic counterpulsation

Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion

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