Intraaortic balloon pump in the management of acute heart failure syndromes

Abstract

Since its introduction by Moulopoulos et al. (1), the intraaortic balloon pump (IABP) has become essential for the treatment of cardiogenic shock. The flexible catheter with a polyurethane balloon mounted at its distal end is placed in the descending thoracic aorta from the femoral artery. Driven by a console, the balloon is deflated during cardiac systole, lowering left ventricular (LV) afterload, and inflated during diastole, increasing aortic diastolic pressure. Interactions between these effects explain the range of physiologic properties of the IABP. According to the Suga-Sagawa law, a linear relation exists between LV end-systolic pressure and end-systolic volume (ESV), if contractility remains unchanged (2,3). The increase in aortic compliance by balloon deflation during systole lowers the aortic and LV systolic pressures, which, according to the law, causes a proportionate decrease in ESV and, in the absence of change in LV end-diastolic volume (EDV), an increase in LV stroke volume and cardiac output. © 2008 Springer-Verlag London.