Monday, April 11, 2011

Intra-aortic Balloon Pump

The intra-aortic balloon pump (IABP) is a mechanical device which reduces cardiac workload by decreasing afterload. It also increases coronary blood flow. The intra-aortic balloon consists of a cylindrical polyethylene balloon which is attached to the end of a catheter, which is threaded up into the aorta where it is inflated and deflated in a regular sequence. The IABP actively deflates in systole, increasing forward blood flow by reducing afterload. It actively inflates in diastole, increasing blood flow to the coronary arteries. These actions combine to decrease myocardial oxygen demand and increase myocardial oxygen supply. This device is indicated in the following heart conditions: acute mitral regurgitation, pump failure, unstable angina pectoris, percutaneous coronary angioplasty, etc.

In 1962 Dr S Moulopoulus from the Cleveland Clinic, developed an experimental prototype of the intra-aortic balloon (IAB) whose inflation and deflation were timed to the cardiac cycle. In 1968 the initial use in clinical practice of the IABP and it`s further improvement was realized resp. continued by A. Kantrowiz`s group. The intra-aortic balloon pump was developed for use in heart surgery by Dr. David Bregman in 1976 at NewYork-Presbyterian Hospital in New York City. The first clinical implant was performed at Maimonides Medical Center, Brooklyn, N.Y. in Oct., 1967. The patient, a 48 year old woman, was in cardiogenic shock and unresponsive to traditional therapy. An IABP was inserted by a cut down on the left femoral artery. Pumping was performed for approximately 6 hours. Shock reversed and the patient was discharged.