Intra-aortic Balloon Pump

Abstract

Intra-aortic balloon pump (IABP) counterpulsation has been the most widely used circulatory assist device for nearly five decades. As a result of diastolic inflation and systolic deflation, coronary blood flow is increased and afterload decreased translating into augmentation of oxygen supply and lowering of oxygen demand. In routine clinical practice, IABP is mainly used in high-risk patients with acute myocardial infarction, especially when complicated by cardiogenic shock. Further, prophylactic IABP is frequently used in patients at high risk for hemodynamic instability undergoing elective percutaneous coronary intervention or coronary artery bypass grafting. However, IABP use may be associated with serious complications, including major bleeding, thromboembolism, stroke, and vascular complications. The potential benefits of IABP must be weighed against these serious complications. This chapter describes mechanism of action, indications and contraindications for use of the IABP, insertion and timing of the device, and troubleshooting measures for common malfunctions.