Heart is the muscular pump that supplies blood to each and every corner of the body and thus it provides oxygen to every tissue. When there is a block in the coronary arteries, which provides oxygenated blood to the heart, the heart dose not get sufficient amount of oxygen, and hence it works too hard to supply oxygenated blood to the tissue resulting in myocardial oxygen demand and other medical complications. In order to assist the heart with an increased oxygen demand, Intra aortic balloon pump was developed.
Intra aortic balloon pump (IABP) is a mechanical circulatory support that is used to increase the myocardial oxygen supply, and it also decreases the work load of the heart by increasing the cardiac output. This device is made of a polyethylene balloon that is attached to the end of a catheter and it is fixed to the descending thoracic aorta, the largest artery, through the femoral artery of the leg. The balloon is connected to the drive console which consists of a monitor for ECG, pressurized gas reservoir, pressure wave recorder, adjustment for inflation and deflation timings, and the battery back up for power supply.
Inflation of the balloon occurs during diastole and gives an increased pressure to the aorta which helps to increase the coronary artery perfusion. The balloon deflates during systole, which causes the ejection of blood from the left ventricles and thus the cardiac output is increased. During the deflation of the balloon, the pressure inside the aorta decreases, and hence the heart need not pump harder. By this way, the left ventricles are prevented from being overworked and at the same time the essential oxygen requirement of the body is also met.
The gas used to inflate the balloon is either helium or carbon dioxide. But the usage of helium gas is preferred over carbon dioxide because of the inertness of the gas and its lower density, which is necessary to be absorbed by the blood stream. Thus,the usage of the helium gas can cause less or no effect when the balloon ruptures. The inflations and the deflations of the balloon are usually aligned with the cardiac cycle of the patients and also with their blood pressure.
IABP is the only method that maintains the aortic pressure and supplies the required oxygen without giving much trouble to the heart. IABP is used mostly in emergency cardiac support conditions like acute heart attack, heart failure, cardio pulmonary bypass, cardiogenic shock, angioplasty,and coronary stent placement.
Aortic dissection, severe peripheral vascular disease, hemorrhage, irreversible brain damage, renal failure, infections, etc. are some of the complications seen associated with usage of IABP.