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Review
. 2016 Aug 4;11(1):122.
doi: 10.1186/s13019-016-0513-0.

IABP: history-evolution-pathophysiology-indications: what we need to know

H Parissis  1 , V Graham  2 , S Lampridis  1 , M Lau  1 , G Hooks  1 , P C Mhandu  1
Affiliations
Review

IABP: history-evolution-pathophysiology-indications: what we need to know

H Parissis et al. J Cardiothorac Surg. .

Abstract

Treatment with the intraaortic balloon pump (IABP) is the most common form of mechanical support for the failing heart. Augmentation of diastolic pressure during balloon inflation contributes to the coronary circulation and the presystolic deflation of the balloon reduces the resistance to systolic output. Consequently, the myocardial work is reduced. The overall effect of the IABP therapy is an increase in the myocardial oxygen supply/demand ratio and thus in endocardial viability.This is an overall synopsis of what we need to know regarding IABP. Furthermore, this review article attempts to systematically delineate the pathophysiology linked with the hemodynamic consequences of IABP therapy. The authors also look at the future of the use of the balloon pump and conclude that the positive multi-systemic hemodynamic regulation during IABP treatment should further justify its use.

Keywords: Internal counterpulsation; Intra-aortic balloon pump; Mechanical circulatory support.

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Figures

Fig. 1
Fig. 1
Description of the circuit between the patient and the intraaortic balloon pump (IABP). The IABP console includes the following: 1) A gas cylinder (usually helium, which has a theoretical advantage according to Hendrickx et al [14]; 2) a gas supply unit; 3) a monitoring system for recording the ECG and blood pressure; 4) a control unit that processes the ECG and generates a triggering signal. The latter unit is used for the timing of inflation and deflation of the balloon via activation of the valve unit, either opening the valve to supply gas or closing it to interrupt the gas flow
Fig. 2
Fig. 2
Haemodynamic function of the balloon. a ECG. b, c Balloon deflation, corresponding to systole during the cardiac cycle, and inflation, corresponding to diastole. d Balloon action. e Aortic pressure curve during balloon function. f Aortic pressure
Fig. 3
Fig. 3
Effect of the intraaortic balloon pump on myocardial oxygen supply (DPTI) and demand (TTI). DPTI – diastolic pressure time index; TTI – tension time index
See this image and copyright information in PMC

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