Intra-aortic balloon pump postcardiac surgery: A literature review
Mansour Jannati1, Armin Attar2
1 Department of Cardiovascular Surgery, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
2 Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
|Date of Submission||24-Apr-2018|
|Date of Decision||05-Jul-2018|
|Date of Acceptance||24-Oct-2018|
|Date of Web Publication||31-Jan-2019|
Dr. Mansour Jannati
Department of Cardiovascular Surgery, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz
Source of Support: None, Conflict of Interest: None
Intra-aortic balloon pump (IABP) has been the most commonly used mechanical assist circulatory device in many postcardiotomy low output disorders for decades. Mechanism of IABP is based on its inflation in time of the diastolic pressure in the aortic root resulting increase in the blood and oxygen amount of the coronary artery and its deflation in left ventricular afterload during the systolic period. Prophylactic and postoperative application of IABP has been suggested by researchers, which has been commonly used in high-risk patients undertaking coronary artery bypass grafting surgery or percutaneous coronary intervention. Other researchers put forward the idea of the percutaneous IABP insertion throughout the left axillary artery as a reliable and relatively well-tolerated approach and also as a recovery tool to bridge patients with end-stage heart failure to heart transplantation. The current review was aimed to give further insight into routine IABP application by presenting the basic principles and trends in the incidence, management, role of IABP recovery, and long-lasting mortality outcomes in patients with cardiovascular disorders and discussing previous and current evidence.
Keywords: Cardiac surgery, intra-aortic balloon pump, postoperative
|How to cite this article:|
Jannati M, Attar A. Intra-aortic balloon pump postcardiac surgery: A literature review. J Res Med Sci 2019;24:6
| Introduction|| |
Application of intra-aortic balloon pumps (IABPs) has been introduced by Kantrowitz et al. in 1968. The theory of IABP has been first applied in patients with cardiogenic shock (CS) after myocardial infarction (MI). They are commonly used as tools for short-term mechanical care in patients with complicated or advanced heart failure (HF). They function to provide sufficient myocardial oxygen amount through increasing diastolic coronary blood flow. In perioperative period of cardiac procedures, application of IABPs as an adjunctive treatment has recommended in patients with ischemic myocardial dysfunction or low cardiac output syndrome., Another application of IABPs is in myocardial ischemia leading to hemodynamic instability which is used in critical clinical states., Despite its wide range application and its priceless features in improving postoperative survival in high-risk patients with cardiac and ventricular dysfunction, the overall hospital mortality rate is still high. All possible complications of IABP including balloon rupture, aortic or iliac artery dissection, thromboembolism, distal ischemia, and thrombocytopenia are attributable to its mechanical action on platelets. It has been found that the time of IABP application is essential in optimal effect outcomes. It has been shown that mortality rate of patients who received IABP was low (18.8%–19.6%) in preoperative circumstances and was medium and high in intraoperative (27.6%–32.3%) and postoperative (39%–40.5%) insertions, respectively. In a study performed in 2001, data showed that preoperative prophylactic IABP application was more effective in high-risk patients. In another study, postcardiopulmonary bypass (CPB) insertion of IABP was associated with highest recovery rate when preoperative infarction or intraoperative ischemic had occurred. Several clinical trials,,,, in patients with CS showed valuable effects of applying IABP. Other studies have been reported the use of significant amount of intra-aortic balloons in high-risk circumstances through or after cardiovascular interventions and in refractory angina cases. An IB indication was conferred to post-MI-CS by the American College of Cardiology/American Heart Association (ACC/AHA) guidelines.
IABP application in cardiac surgery with function of the balloon within the arterial tree is of interest. Since several approaches regarding IABP application in pre/postoperative condition have been described, we aimed to review the previous and recent experiences in this regard and evaluate the potential management of IABP application, with specific focus on postcardiac surgery.
| Historical Review of Intra-Aortic Balloon Pump Origins|| |
As it is indicated by previously published studies, the principal step for coronary perfusion is cardiac diastole which it is enhanced by rising the diastolic aortic pressure or “diastolic augmentation.”, In the original model of IABP, the counterpulsation term is referred to removal and reinjection of blood into the aorta in opposite way or vice versa to the cardiac cycle. Counterpulsation then led to add sufficient volume of blood to the aorta during the diastole which increased oxygen availability and diastolic blood and perfusion pressure to the coronary and systemic circulation. Practicability of counterpulsation in failing left ventricle recovery had been observed by early experiments, but until then, this approach was not clinically practical.,
By application of a rubber tube between aorta and coronary artery in 1953 which is the base of IABP technology, Adrian and Kantrowitz succeed to postpone the systolic pulsation movement into diastole. A catheter or tube with a volume compartment was applied to fill or empty by a gas such as helium or carbon dioxide for hemodynamic homeostasis.
In 1962, in order to develop a long-lasting cardiac support tool, a cardiac cycle-triggered intra-aortic counterpulsation using a carbon dioxide-driven latex balloon was practically used by Moulopoulos et al. and Clauss et al. The nonflexible polyurethane balloon derived from “faster” helium shuttle gas was evaluated and IABP applied in clinical practice. The hemodynamic benefit of IABP with improvement in coronary perfusion has been indicated by Scheidt et al. in 1973. In 2011, the helium as the drive gas was more applied in all IABP systems in order to its low molecular weight to optimize inflation and deflation.
| Advantages, Benefits, and Application of Intra-Aortic Balloon Pump|| |
Intra-aortic balloon counterpulsation (IABC) is more applied than bypass devices and total heart replacement, after almost 50 years. IABPs are applicable in both left and right ventricular myocardium through both systole and diastole.
The major advantages of them are that they are minimally invasive, prevent from blood handling outside the body, function in series with the heart, inhibit hemolysis, and easily apply by both physicians and cardiologists., The less documented benefit of IABC is the relationship which appears between its relief rate and the left ventricular output. The “garden hose effect” is a phenomenon which increases myocardial contractility.
Recommended indications for application of IABP comprise disorders including ongoing instable angina, acute myocardial ischemia/infarction associated with percutaneous transluminal coronary angioplasty, perioperative low cardiac output syndrome, CS after MI, congestive HF, and connection to heart transplantation.,,,
| Limitation of the Intra-Aortic Balloon Counterpulsation|| |
One of the most important limitations of IABC is its limitation in systolic aortic pressure <50–60 mm Hg. The balloons in the aortic space have one inflow valve, but no outflow valve which is resolved by using two balloons in the aorta. In order to overcome the problem of insufficient flow during the cardiac arrest, physicians try to combine an intra-aortic balloon with a spherical balloon in the left ventricle.
| The Most Common Complications Related With Intra-Aortic Balloon Pump|| |
Common problems which observed after IABP insertion composed of vascular complications with high incidence rate, limb ischemia, local and systemic infection, balloon rupture/damage, passage failure, thrombectomy, vascular repair, and aortic perforation/dissection. The main risk factors of vascular complications include history of peripheral vascular disease, female gender, smoking history, diabetes mellitus, and postoperative IABP replacement.
| Bridge to Recovery: Transaxillary Artery Intra-Aortic Balloon Pump Placement|| |
This replacement applies to extend mechanical circulatory support of patients with postcardiotomy shock. In a literature review, a study of case series has been found that transaxillary artery IABP was well tolerated by patients who had postcardiotomy HF. No infection, thromboembolic, cerebrovascular, bleeding, or IABP malpositioning or movement complications was not observed in patients. Transaxillary artery IABC has been introduced as a tool for early ambulation and aggressive physical therapy in patients needing prolonged support.
| Perfusion Therapy With Either Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting in Patients With Cardiogenic Shock|| |
Several studies have compared the mechanical support of different devices as abridge to recovery of patients before and after cardiac surgery.,,,, CS considered as a physiologic state in which cardiac pump function is malfunctioned to permeate the tissues., Due to organ dysfunction in patients with CS, it is essential to recognize and treat its myriad of signs and symptoms ranging from subtle hemodynamic alterations to overt cardiovascular collapse quickly. Application of mechanical devices along with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for blood circulation support is common in those CS patients who do not respond to pharmacologic therapy.,
Different tools including IABP, percutaneous ventricular assist device (pVAD), and extracorporeal life support (ECLS) have been introduced as common tools for CS recovery. Due to the lack of sufficient evidence, one-to-one superiority has not yet been proven. The IABP has been introduced as the most common mechanical device in CS therapy. However, there is a lack of evidence concerning its efficacy in patients' outcomes. Indeed, IABP has been recommended for patients who do not response to the pharmacologic therapies such as vasopressor, and inotropes based on ACC/AHA ST-Elevation Myocardial Infarction (STEMI) guidelines recommend IABP. Evidence showed that the pVAD is the better choice with more robust role in circulatory support than the IABP. ECLS is considered as a novel supporting device with better outcome and progressive mortality rate in patients suffering from CS. Extracorporeal membrane oxygenation (ECMO) including veno-venous ECMO and veno-arterial ECMO is the most applicable kind of ECLS.
| Time Schedule of Intra-Aortic Balloon Pump Effectiveness|| |
Timing is a promising issue in favorable hemodynamic effects of IABPs. It is the process to monitor the periods during the cardiac cycle caused by the balloon inflation, its inflation length, and the exact time of its deflation. Many cardiovascular health-care systems have adjusted the timing setting to incorporate modifications in heart pulse rate. However, it is better that the physicians set and record the initial timing and hemodynamic changes. These difficulties have been matched with advanced technologies and use of automatically timing settings.
Two generally approaches has been accepted for IABP timing; conventional and real-time (R-wave deflation). The most obvious difference between these two timing methods is the inflation and deflation of the IABP. In conventional timing, IABP inflation and deflation totally occur within the diastolic phase, while, in real-time method, deflation occurs during the preejection or early systolic ejection phase which may cause stroke volume due to active deflation through the systolic ejection.,,,,
| The Sound Alarms of the Intra-Aortic Balloon Pump during Aortic Counterpulsation Treatment|| |
With the purpose of increase in myocardial perfusion and subsequently, in the decreased possibility of fatal arrhythmias, including ventricular fibrillation, ventricular tachycardia, and acute coronary syndrome, the IABP-cycling technologies should be equipped with a system of clinical alarms such the asynchronism alarm. These alarms have been designed to alert the professional teams to be aware of a possible lack in synchronism processes causing life risk of patients. Complications of setting off in asynchronism alarm result in myocardial perfusion reduction perfusion and consequently in fatal arrhythmias.
In an observational and descriptive study, the role of alarms in IABP management was evaluated with the aim to reduce the alarm fatigue occurrence and to offer a safety in patients who depend on this technology. Their finding showed the pivotal role of medical equipment in the monitoring of patients which themselves need to care cautiously to decrease complications in patients who use these devices.
| Application of Intra-Aortic Balloon Pump and Its Timing in Off-Pump Coronary Artery Bypass Grafting Surgery|| |
Application of IABP is recommended in the case of complications including CS, low cardiac output syndrome, left ventricular failure, mechanical complication of myocardial infarction (such as ventricular septal defect, severe acute mitral valve regurgitation, and papillary muscle rupture), refractory unstable angina, and during high-risk PCI. One of the best surgical methods to eliminate CPB complications is off-pump CABG (OPCAB).,, It is a kind of surgery accompanied by hemodynamic instability due to the heart displacement to expose target vessels. It has been shown that the prophylactic insertion of IABP has benefit before OPCAB resulting improvement of cardiac performance and ease in target vessel accessibility without any hemodynamic instability. Findings confirmed that preoperative insertion of IABP more than 2 h before OPCAB has better efficacy, especially in high-risk patients with higher EuroSCORE. OPCAB surgery has gained widespread acceptance because it eliminates the problems associated with CPB.
| Ventricular Magnetic Resonance Imaging-Based (Three-Dimensional) Electromechanical Model|| |
Despite the efficacy of IABP application in mitral regurgitation (MR), it is normally contraindicated in aortic regurgitation (AR). Coexistence of AR along with the IABP application is of clinical significance.
IABP efficacy on ventricular workload could be evaluated and quantified by indirect parameters including the mean systolic pressure, product of heart rate and peak systolic pressure, and pressure–volume. However, there is a lack of evidence in terms of IABP workload quantification due to low spatiotemporal resolution of myocardial energy use through the ventricular volume. Computational modeling has been developed as an alternative method to overcome this limitation.
Methods such as three-dimensional (3D) model of cardiac electrophysiology for monitoring of failing ventricles have been developed in combination with a lumped model of the circulatory system., Another approach with the aim to evaluate failing ventricles with mitral and aortic valve regurgitations and the local contractile energy consumption of the myocardium quantification has also been introduced.
In recently published study, combination of 3D electromechanical model and a lumped parameter model of valvular regurgitation was assessed valvular insufficiency condition including the AR and MR in failing ventricle and the IABP therapy. The clinical contraindication of IABP was observed in AR patients compared to its effective role in the MR condition.
| Discussion|| |
Coronary blood flow could be increased by the application of IABPs resulting in left ventricular afterload reduction. IABP technology is applied to increase the time of heart recovery in patients with low cardiac output condition undergoing a CPB or ischemic events. Postoperative HF has been suggested as the single indication of IABP application in previously published studies., Several factors such as advanced age could be altered the duration of postoperative recovery in different complications including cardiovascular disease. Patients with advanced age need a longer postoperative recovery time compared to patients with middle age or younger. For this reason, patients with advanced age may require more mechanical support, especially in the cases of low cardiac output following CPB or CABG. Despite the reported complications of IABP such as bleeding, aorta-iliac injury, and thrombocytopenia, it is widely used in recent times. In order to decrease inhospital mortality rate of patients (ranging 26%–50%) with the cardiac problems, application of IABP support is highly recommended., With increase in the number of patients with advanced age who undergone CABG, IABP application is more highlighted in clinical practice.,,,
Although several studies have shown efficacy of IABP in surgical mortality rate of patients, there have been insufficient evidence regarding clinical outcomes of IABP in surgical patients. In the current review, we aimed to evaluate and compare IABP application in different conditions of CVD with specially focus on in postoperative aspects, clinical features, timing, intensive care unit, hospital stays, and morbidity and mortality rates in patients who had required IABP support and undergone different cardiac surgeries such as CABG or CPB. As previously described in the 1960s, IABPs had been applied in clinical practice as a CS therapy after MI and drug therapy-resistant unstable angina. Findings of a study performed in 2011 showed that IABP was associated with decrease in the mortality rates of patients with low cardiac output and severe myocardial ischemia in the preoperative period and avoid medically refractory arrhythmias in the postoperative period of patients in intensive care unit. In another study in 2015, IABP was applied to recover low cardiac output, persistent angina pectoris, or arrhythmia in preoperative phase of patients with myocardial ischemia. Thiele et al. in 2013 found that IABP counterpulsation had no significant effect on mortality rate of patients with CS. In contrast, Remeo et al. indicated that IABP was efficient in reperfusion quality of patients with primary PCI after thrombolytic therapy without any increase inhospital mortality. Other randomized clinical trial in 2012 demonstrated that IABP counterpulsation had no different effect on cardiac output, left ventricular stroke work index among the patient group compared to the control one. In a meta-analysis of 1034 patients, the significant role of preoperative IABP application in high-risk patients and in mortality rate reduction has been suggested. Another finding indicated that preoperative IABP was effective on the length of the hospital stay without any positive effect on morbidity and mortality rates. Saha et al.observed complete revascularization in patients with hemodynamic instability who had an IABP. In a cohort study, data showed no association between IABP insertion and a long-term survival benefit. Zelano et al. demonstrated that inflation and deflation of the left ventricle occur in different time. Therefore, counterpulsation therapy goals should be determined before selection of the timing method or settings.
To overcome worse outcome of cardiovascular disorders diseases, it should be essential to protect cardiac system during cardiac surgery. Therefore, therapeutic strategies are needed to decrease postoperative complications in which IABP has become as the myocardial protective strategy of choice. However, a number of variations should be considered in IABP insertion, including advanced age, duration and timing of IABP support intervention with no complications, several physiological and nonphysiological factors such as the patient's cardiac function, hemodynamic circumstances, the position and size of the intra-aortic balloon catheter, the anatomy of the coronary arteries, the condition of the myocardium, and its indication quality and reliability. Therefore, the optimum time of IABP prophylactic therapy requires further study, since the intervention timing had not accurately been assessed in previous studies.
Since IABP clinical benefit is still debated and also there is a controversy between the findings of different studies, physicians, cardiologists, and surgeon should be knowledgeable about the possible factors that interrupt IABC efficacy and this information should be considered in IABP hemodynamic evaluation. As a general rule, the application of IABC in the era of interventional revascularization is highly recommended by many cardiologists and cardiac specialists at high-risk patients. In conclusion, IABP support should be still applied after cardiac surgery in high-risk cohort of patients with postcardiotomy low output syndrome.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kantrowitz A, Tjonneland S, Freed PS, Phillips SJ, Butner AN, Sherman JL Jr. Initial clinical experience with intraaortic balloon pumping in cardiogenic shock. JAMA 1968;203:113-8.
Mehlhorn U, Kröner A, de Vivie ER. 30 years clinical intra-aortic balloon pumping: Facts and figures. Thorac Cardiovasc Surg 1999;47 Suppl 2:298-303.
Cheng JM, den Uil CA, Hoeks SE, van der Ent M, Jewbali LS, van Domburg RT, et al.
Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: A meta-analysis of controlled trials. Eur Heart J 2009;30:2102-8.
Scheidt S, Wilner G, Mueller H, Summers D, Lesch M, Wolff G, et al.
Intra-aortic balloon counterpulsation in cardiogenic shock. Report of a co-operative clinical trial. N Engl J Med 1973;288:979-84.
Craver JM, Kaplan JA, Jones EL, Kopchak J, Hatcher CR. What role should the intra-aortic balloon have in cardiac surgery. Ann Surg 1979;189:769-76.
Kern MJ, Aguirre F, Bach R, Donohue T, Siegel R, Segal J, et al.
Augmentation of coronary blood flow by intra-aortic balloon pumping in patients after coronary angioplasty. Circulation 1993;87:500-11.
Sjauw KD, Engström AE, Henriques JP. Percutaneous mechanical cardiac assist in myocardial infarction. Where are we now, where are we going? Acute Card Care 2007;9:222-30.
Kucuker A, Cetin L, Kucuker SA, Gokcimen M, Hidiroglu M, Kunt A, et al.
Single-centre experience with perioperative use of intraaortic balloon pump in cardiac surgery. Heart Lung Circ 2014;23:475-81.
Fitzmaurice GJ, Collins A, Parissis H. Management of intra-aortic balloon pump entrapment: A case report and review of the literature. Tex Heart Inst J 2012;39:621-6.
Creswell LL, Rosenbloom M, Cox JL, Ferguson TB Sr., Kouchoukos NT, Spray TL, et al.
Intraaortic balloon counterpulsation: Patterns of usage and outcome in cardiac surgery patients. Ann Thorac Surg 1992;54:11-8.
Christenson JT, Schmuziger M, Simonet F. Effective surgical management of high-risk coronary patients using preoperative intra-aortic balloon counterpulsation therapy. Cardiovasc Surg 2001;9:383-90.
Stone GW, Ohman EM, Miller MF, Joseph DL, Christenson JT, Cohen M, et al.
Contemporary utilization and outcomes of intra-aortic balloon counterpulsation in acute myocardial infarction: The benchmark registry. J Am Coll Cardiol 2003;41:1940-5.
Moulopoulos S, Stamatelopoulos S, Petrou P. Intraaortic balloon assistance in intractable cardiogenic shock. Eur Heart J 1986;7:396-403.
Ohman EM, George BS, White CJ, Kern MJ, Gurbel PA, Freedman RJ, et al.
Use of aortic counterpulsation to improve sustained coronary artery patency during acute myocardial infarction. Results of a randomized trial. The randomized IABP study group. Circulation 1994;90:792-9.
Lorente P, Gourgon R, Beaufils P, Masquet C, Rosengarten M, Azancot I, et al.
Multivariate statistical evaluation of intraaortic counterpulsation in pump failure complicating acute myocardial infarction. Am J Cardiol 1980;46:124-34.
Hudson M, Granger C, Stebbins A, White H, Bates E, Greenbaum A, et al
. Cardiogenic shock survival and use of intraaortic balloon counterpulsation: Results from the GUSTO I and III Trials. Circulation 1999;100: 2067-73.
Sjauw KD, Engström AE, Vis MM, van der Schaaf RJ, Baan J Jr., Koch KT, et al.
A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: Should we change the guidelines? Eur Heart J 2009;30:459-68.
Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al.
ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction – Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction). Circulation 2004;110:588-636.
Gregg DE. Physiology of the coronary circulation. Ann N
Y Acad Sci 1960;90:145-55.
Hanlon-Pena PM, Quaal SJ. Intra-aortic balloon pump timing: Review of evidence supporting current practice. Am J Crit Care 2011;20:323-33.
Weber KT, Janicki JS, Walker AA. Intra-aortic balloon pumping: An analysis of several variables affecting balloon performance. Trans Am Soc Artif Intern Organs 1972;18:486-92.
Kantrowitz A. Experimental augmentation of coronary flow by retardation of the arterial pressure pulse. Surgery 1953;34:678-87.
Moulopoulos SD, Topaz S, Kolff WJ. Diastolic balloon pumping (with carbon dioxide) in the aorta – A mechanical assistance to the failing circulation. Am Heart J 1962;63:669-75.
Clauss R, Missier P, Reed G, Tice D, editors. Assisted Circulation by Counter-Pulsation with an Intra-Aortic Balloon. Methods and Effects. Annual Conference on Engineering in Medicine and Biology, Chicago: Illinois; 1962.
Schilt W, Freed PS, Khalil G, Kantrowitz A. Temporary non-surgical intraarterial cardiac assistance. ASAIO J 1967;13:322-7.
Moulopoulos SD, Anthopoulos LP, Stamatelopoulos SF, Boufas DG. Optimal changes in stroke work during left ventricular bypass. J Appl Physiol 1973;34:12-7.
Moulopoulos SD. Intra-aortic balloon counterpulsation 50 years later: Initial conception and consequent ideas. Artif Organs 2011;35:843-8.
Arnold G, Morgenstern C, Lochner W. The autoregulation of the heart work by the coronary perfusion pressure. Pflugers Arch 1970;321:34-55.
Torchiana DF, Hirsch G, Buckley MJ, Hahn C, Allyn JW, Akins CW, et al.
Intraaortic balloon pumping for cardiac support: Trends in practice and outcome, 1968 to 1995. J Thorac Cardiovasc Surg 1997;113:758-64.
Fischer U, Mehlhorn U. Intra-aortic balloon counterpulsation (IABP). Recommendations for use of the Life-support-machine; 2006. p. 217-23.
De Vivie E, Hellberg K, Kettler D. Basics of Intra-Ordinal Balloon pulsation. Intraoral Balloon Pulsation (IABP), Stuttgart; 1977.p. 14-24.
Preuße C, Schulte H. Intra-aortic balloon counterpulsation (IABP): A location determination. New ways in the Heart-lung machine technique and the assisted Circulation. Springer; 1992. p. 9-17.
Moulopoulos SD, Stamatelopoulos SF, Zacopoulos NA, Saridakis NS, Adractas AJ, Stefanou SA, et al.
Intraventricular plus intra-aortic balloon pumping during intractable cardiac arrest. Circulation 1989;80:III167-73.
Nwaejike N, Son AY, Patel CB, Schroder JN, Milano CA, Daneshmand MA, et al.
The axillary intra-aortic balloon pump as a bridge to recovery allows early ambulation in long-term use: Case series and literature review. Innovations (Phila) 2017;12:472-8.
De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, et al.
Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010;362:779-89.
Shah P, Cowger JA. Cardiogenic shock. Crit Care Clin 2014;30:391-412.
Hochman JS, Sleeper LA, Webb JG, Dzavik V, Buller CE, Aylward P, et al.
Early revascularization and long-term survival in cardiogenic shock complicating acute myocardial infarction. JAMA 2006;295:2511-5.
O'Gara PT, Kushner FG, Ascheim DD, Casey DE Jr., Chung MK, de Lemos JA, et al.
2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013;127:e362-425.
Tewelde SZ, Liu SS, Winters ME. Cardiogenic shock. Cardiol Clin 2018;36:53-61.
Thiele H, Schuler G, Neumann FJ, Hausleiter J, Olbrich HG, Schwarz B, et al.
Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: Design and rationale of the intraaortic balloon pump in cardiogenic shock II (IABP-SHOCK II) trial. Am Heart J 2012;163:938-45.
O'Gara PT, Kushner FG, Ascheim DD, Casey DE Jr., Chung MK, de Lemos JA, et al.
2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: Executive summary: A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013;127:529-55.
Kar B, Gregoric ID, Basra SS, Idelchik GM, Loyalka P. The percutaneous ventricular assist device in severe refractory cardiogenic shock. J Am Coll Cardiol 2011;57:688-96.
Tharmaratnam D, Nolan J, Jain A. Management of cardiogenic shock complicating acute coronary syndromes. Heart 2013;99:1614-23.
Kern MJ, Aguirre FV, Tatineni S, Penick D, Serota H, Donohue T, et al.
Enhanced coronary blood flow velocity during intraaortic balloon counterpulsation in critically ill patients. J Am Coll Cardiol 1993;21:359-68.
Papaioannou TG, Stefanadis C. Basic principles of the intraaortic balloon pump and mechanisms affecting its performance. ASAIO J 2005;51:296-300.
Kern MJ, Aguirre FV, Caracciolo EA, Bach RG, Donohue TJ, Lasorda D, et al.
Hemodynamic effects of new intra-aortic balloon counterpulsation timing methods in patients: A multicenter evaluation. Am Heart J 1999;137:1129-36.
Tyson G, Davis J, Rankin J. Improved performance of the intra-aortic balloon pump in man. Surg Forum 1986;37:214–6.
Franco AS, Bridi AC, Karam MA, Moreira AP, Andrade KB, Silva RC, et al.
Stimulus-response time to alarms of the intra-aortic balloon pump: Safe care practices. Rev Bras Enferm 2017;70:1206-11.
Cardiologia SB. Brazilian guideline for acute heart failure 2009. Arq Bras Cardiol 2012;93:1-65.
Covino E, D'Auria F. Intra-aortic balloon pump: Towards continuous monitoring of control parameters. Minerva Anestesiol 2013;79:713-5.
Emmert MY, Salzberg SP, Seifert B, Rodriguez H, Plass A, Hoerstrup SP, et al.
Is off-pump superior to conventional coronary artery bypass grafting in diabetic patients with multivessel disease? Eur J Cardiothorac Surg 2011;40:233-9.
Marui A, Okabayashi H, Komiya T, Tanaka S, Furukawa Y, Kita T, et al.
Benefits of off-pump coronary artery bypass grafting in high-risk patients. Circulation 2012;126:S151-7.
García Fuster R, Paredes F, García Peláez A, Martín E, Cánovas S, Gil O, et al.
Impact of increasing degrees of renal impairment on outcomes of coronary artery bypass grafting: The off-pump advantage. Eur J Cardiothorac Surg 2013;44:732-42.
Liu F, Yang F, Du Z, Miao N, Zhao Y, Xu B, et al.
Timing of intra-aortic balloon pump placement before off-pump coronary artery bypass grafting and clinical outcomes. Artif Organs 2018;42:263-70.
Levine AJ, Dimitri WR, Bonser RS. Aortic regurgitation in rheumatoid arthritis necessitating aortic valve replacement. Eur J Cardiothorac Surg 1999;15:213-4.
Kim CH, Song KS, Trayanova NA, Lim KM. Computational prediction of the effects of the intra-aortic balloon pump on heart failure with valvular regurgitation using a 3D cardiac electromechanical model. Med Biol Eng Comput 2018;56:853-63.
Lim KM, Constantino J, Gurev V, Zhu R, Shim EB, Trayanova NA, et al.
Comparison of the effects of continuous and pulsatile left ventricular-assist devices on ventricular unloading using a cardiac electromechanics model. J Physiol Sci 2012;62:11-9.
Lim KM, Lee JS, Gyeong MS, Choi JS, Choi SW, Shim EB, et al.
Computational quantification of the cardiac energy consumption during intra-aortic balloon pumping using a cardiac electromechanics model. J Korean Med Sci 2013;28:93-9.
Lim KM, Hong SB, Lee BK, Shim EB, Trayanova N. Computational analysis of the effect of valvular regurgitation on ventricular mechanics using a 3D electromechanics model. J Physiol Sci 2015;65:159-64.
Yumun G, Aydin U, Ata Y, Toktaş F, Pala AA, Ozyazicioglu AF, et al.
Analysis of clinical outcomes of intra-aortic balloon pump use during coronary artery bypass surgery. Cardiovasc J Afr 2015;26:155-8.
Leinbach RC, Buckley MJ, Austen WG, Petschek HE, Kantrowitz AR, Sanders CA. Effects of intra-aortic balloon pumping on coronary flow and metabolism in man. Circulation 1971;43:I77-81.
Swank M, Singh HM, Flemma RJ, Mullen DC, Lepley D Jr. Effect of intra-aortic balloon pumping on nutrient coronary flow in normal and ischemic myocardium. J Thorac Cardiovasc Surg 1978;76:538-44.
Gilotra NA, Stevens GR. Temporary mechanical circulatory support: A review of the options, indications, and outcomes. Clin Med Insights Cardiol 2014;8:75-85.
MacGee E, MacCarthy P, Moazami N. Cardiac Surgery in the Adult. Cohn LH. Temporary Mechanical Circulatory Support. McGraw-Hill Medical: NY; Vol. 3. 2008. p. 507-33.
Dalrymple-Hay MJ, Alzetani A, Aboel-Nazar S, Haw M, Livesey S, Monro J, et al.
Cardiac surgery in the elderly. Eur J Cardiothorac Surg 1999;15:61-6.
Wiegmann B, Ismail I, Haverich A. Cardiac surgery in the elderly. Chirurg 2017;88:110-5.
Ryckwaert F, Chaptal PA, Colson P. Cardiac surgery in the elderly. Anesthesiol Phila Hagerstown 2000;93:A52.
Casado JM. Cardiac surgery and the elderly. Rev Esp Cardiol 2008;61:564-6.
Theologou T, Bashir M, Rengarajan A, Khan O, Spyt T, Richens D, et al
. Preoperative intra aortic balloon pumps in patients undergoing coronary artery bypass grafting. Cochrane Libr 2011;19:CD004472.
Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, et al.
Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): Final 12 month results of a randomised, open-label trial. Lancet 2013;382:1638-45.
Prondzinsky R, Lemm H, Swyter M, Wegener N, Unverzagt S, Carter JM, et al.
Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: The prospective, randomized IABP SHOCK trial for attenuation of multiorgan dysfunction syndrome. Crit Care Med 2010;38:152-60.
Dyub AM, Whitlock RP, Abouzahr LL, Cinà CS. Preoperative intra-aortic balloon pump in patients undergoing coronary bypass surgery: A systematic review and meta-analysis. J Card Surg 2008;23:79-86.
Holman WL, Li Q, Kiefe CI, McGiffin DC, Peterson ED, Allman RM, et al.
Prophylactic value of preincision intra-aortic balloon pump: Analysis of a statewide experience. J Thorac Cardiovasc Surg 2000;120:1112-9.
Saha KK, Kaushal RP, Kumar A, Deval M, Saha KK, Kaul SK, et al.
Intraaortic balloon pump boon for off-pump coronary artery bypass grafting. Asian Cardiovasc Thorac Ann 2015;23:267-70.
Rathod KS, Koganti S, Iqbal MB, Jain AK, Kalra SS, Astroulakis Z, et al.
Contemporary trends in cardiogenic shock: Incidence, intra-aortic balloon pump utilisation and outcomes from the london heart attack group. Eur Heart J Acute Cardiovasc Care 2018;7:16-27.
Zelano JA, Li JK, Welkowitz W. A closed-loop control scheme for intraaortic balloon pumping. IEEE Trans Biomed Eng 1990;37:182-92.
Baran DA, Visveswaran GK, Seliem A, DiVita M, Wasty N, Cohen M, et al.
Differential responses to larger volume intra-aortic balloon counterpulsation: Hemodynamic and clinical outcomes. Catheter Cardiovasc Interv 2017;92:703-10.