Basic Principles of the Intraaortic Balloon Pump and Mechanisms Affecting Its Performance

  title={Basic Principles of the Intraaortic Balloon Pump and Mechanisms Affecting Its Performance},
  author={Theodoros G. Papaioannou and Christodoulos Stefanadis},
  journal={ASAIO Journal},
The intraaortic balloon pump (IABP) is the single most effective and widely used device for temporary mechanical assistance of the failing heart. Although the principles underlying IABP function are simple, various biologic factors often determine its performance in a particularly complicated way. We briefly describe the basic disciplines of counterpulsation by IABP and the induced hemodynamic changes while clarifying the biologic mechanisms that play a crucial role in the modification of IABP… 

The Intra-aortic Balloon Pump

With continued advancements in the technology, the intra-aortic balloon pump is the most commonly used mechanical cardiac assist device in critically ill patients.

Controlling axillary intra-aortic balloon pump inflation is a viable option for turning an acute heart failure patient into a chronic one.

Intra-aortic balloon pump is often used to support patients in decompensated heart failure and may allow for the conversion of an acute heart failure patient into a chronic HF patient using a modified weaning protocol; allowing for medical symptom management and removal of mechanical support.

Positioning an intraaortic balloon pump using intraoperative transesophageal echocardiogram guidance.

A 72-year-old man with an ejection fraction of 25% is scheduled to undergo elective coronary artery bypass graft using cardiopulmonary bypass, and an intraoperative transesophageal echocardiogram is requested to ensure correct placement.

Mechanical Circulatory Support for the Failing Heart: Which Device to Choose

An algorithm for the treatment of cardiogenic shock is provided and it is shown that the decision to use extracorporeal mechanical support must be made early in the clinical presentation, and is best done in a multidisciplinary fashion.

Hemodynamic and Metabolic Effects of Para- versus Intraaortic Counterpulsatile Circulation Supports

The acute hemodynamic and metabolic efficacy of a novel 40-ml stroke volume paraaortic blood pump (PABP) versus a standard intraaortic balloon pump (IABP) is explored and a trend toward PABP superiority in reducing left ventricular SW is seen.

Intra-aortic balloon counterpulsation in decompensated cardiomyopathy patients: bridge to transplantation or assist device (cid:2)

The data showed that intra-aortic balloon pump support may be successfully and safely used in the acute decompensated dilated cardiomyopathy patients, as an urgent measure of cardiac support, to stabilize the patient and maintain organ perfusion until transplant is available, VAD is placed or patient is weaned from IABP.

Percutaneous Mechanical Circulatory Support Technologies

Over the past decade, alternative devices, including the Impella devices and venoarterial extracorporeal membrane oxygenation (ECMO), that offer more robust hemodynamic support have been used with increased frequency to treat CS.

Acute Hemodynamic Efficacy of a 32-ml Subcutaneous Counterpulsation Device in a Calf Model of Diminished Cardiac Function

The CPD provides hemodynamic efficacy equivalent to an IABP and may become a therapeutic option for patients who may benefit from prolonged counterpulsation.

Comparison of effects of extra-thoracic paraaortic counterpulsation to intraaortic balloon pump on circulatory support in acute heart failure

ETPACD with theoretical larger stroke volume may become a promising counterpulsation device for treatment of heart failure and provide benefit of circulatory support in acute heart failure with better effect on hemodynamic parameters.

Pressure-Wave Energy Relationship during IABP Counterpulsation in a Mock Circulation: Changes with Angle and Assisting Frequency

This study shows that, in vitro, a greater benefit of counterpulsation can be achieved in the horizontal position at 1:1 assisting frequency, with a good correlation between wave and pressure results.



Mechanical intraaortic cardiac assistance in cardiogenic shock. Hemodynamic effects.

The results of the animal studies utilizing balloon pumping indicated that the assistance procedure effectively supports the circulation of animals in induced shock or left ventricular failure, and it was evident that prolonged pumping had no adverse effects on either the subject or the equipment.

Counterpulsation: historical background, technical improvements, hemodynamic and metabolic effects.

The salutary hemodynamic effects of the IABP have been shown in several experimental studies and the technical improvements and the development and use of new devices suggest that the authors still need to learn more about the usefulness of the counterpulsation technique.

Clinical and Hemodynamic Results of Intraaortic Balloon Pumping and Surgery for Cardiogenic Shock

IABP is a safe, effective means of supporting the circulation in CS-MI, and IABP alone will improve survival in some patients, and some patients with CS- MI have myocardial necrosis too extensive to permit survival without permanent circulatory assistance or total cardiac replacement.

Intra-aortic balloon counterpulsation in cardiogenic shock. Report of a co-operative clinical trial.

Patients with cardiogenic shock were treated with the intra-aortic counterpulsating balloon in 10 institutions according to a common protocol, and clinical and physiologic problems were found.

Hemodynamic effects of a counterpulsation device implanted on the ascending aorta in severe cardiogenic shock.

The CD has significant salutary hemodynamic effects in severe cardiogenic shock where the IABP is ineffective, and the CD had a significant beneficial effect in all measured parameters.

Initial clinical experience with intraaortic balloon pumping in cardiogenic shock.

Although final evaluation must await more data, balloon pumping appears to be effective in cardiogenic shock, and further study may establish a place for the procedure in myocardial infarction without cardiogenesis shock and in low cardiac output syndromes associated with open-heart surgery.

The Limits of Counterpulsation

  • S. Moulopoulos
  • Medicine, Biology
    The International journal of artificial organs
  • 1993
Mechanical assistance to the failing left ventricle may be necessary and has been used with the intention a) of maintaining an adequate circulation until the heart is replaced by a transplant

The efficacy of the high volume counterpulsation technique at very low levels of aortic pressure.

The very low levels of the systolic aortic pressure was the most important factor precluding the adequate effectiveness of the counterpulsation technique.