Intra Aortic Balloon Pumps

By Dr Ray Raper  

In the 1960s, cardiac surgeon Dr Adrian Kantrowitz pioneered the intra-aortic balloon pump – a surgically implantable device that provided mechanical circulatory support in patients following cardiac surgery. These days, it is a widely used, invaluable piece of equipment that is often inserted and removed in the intensive care unit.

IABPs increase coronary blood flow and reduced myocardial demand and are therefore ideal for augmenting cardiac function post operatively, in cardiogenic shock and in reversible intracardiac mechanical failure e.g acute mitral regurgitation or VSD.

The device consist of a cylindrical polyethylene balloon that sits in the descending aorta approximately 2cm from the left subclavian artery. It is attached to an external computer via the femoral insertion site which automatically (manual settings are usually available) controls the inflation/deflation of the balloon with helium. Essentially, the balloon deflates during systole to reduce afterload and inflates during diastole to increase blood flow through the coronary arteries.

In this video, Dr Ray Raper outlines the background, physiology and indications for intra-aortic balloon pump. He also demonstrates the technique for insertion of the balloon including balloon sizing and position, vascular access via the femoral artery and the Saldinger technique for insertion. He shares his invaluable experience with using IABPs and describes tips and tricks to ensure maximal patient benefit from these devices.

A representative from Maquet demonstrate the device and computer control system. She outlines equipment set up, how the equipment runs in automatic mode and troubleshooting of common issues.