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Intraaortic Balloon Pump in the Management of Acute Heart Failure Syndromes

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Acute Heart Failure

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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.

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Authors and Affiliations

  1. Department of Clinical Therapeutics, University of Athens, Athens, Attica, Greece

    Eleftheria P. Tsagalou MD, Elias Tsolakis MD & John N. Nanas MD, PhD

  2. Clinical Therapeutics, University of Athens, Athens, Attica, Greece

    Stavros G. Drakos MD

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  1. Eleftheria P. Tsagalou MD
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  3. Elias Tsolakis MD
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Editors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Alexandre Mebazaa MD, PhD (Professor of Medicine) (Professor of Medicine)

  2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mihai Gheorghiade MD, FACC (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service) (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service)

  3. Department of Cardiology Centre d’Investigation Clinique (CIC), INSERM U-684, Centre Hospitalier Universitaire, University Henri Poincaré, Nancy, France

    Faiez M. Zannad MD, PhD, FESC (Professor of Medicine) (Professor of Medicine)

  4. Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

  5. Cooper Heart Institute, Cooper University Hospital, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

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Tsagalou, E.P., Drakos, S.G., Tsolakis, E., Nanas, J.N. (2008). Intraaortic Balloon Pump in the Management of Acute Heart Failure Syndromes. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_61

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