The Japanese journal of surgery

, Volume 8, Issue 4, pp 282–290 | Cite as

Use of intra-aortic balloon pumping (IABP) in clinical cardiac surgery and management of patients with IABP

  • Hiroshi Watanabe
  • W. Dudley Johnson
  • Richard T. Shore
  • Kenneth L. Kayser


One hundred thirty eight patients were reviewed which required IABP assist. Sixty nine (84 per cent) of 82 patients who had been able to come off cardiopulmonary bypass despite increasing pharmacologic support survived operation and 56 patients (68 per cent) discharged hospital. Twenty three (75 per cent) of 31 patients who took for elective coronary artery surgery as extremely high risk because of extensive three vessel coronary artery disease and severely compromised left ventricular function discharged hospital. In summary, hospital death was 35 per cent, late death 12 per cent and long term survivors 54 per cent. Severe complication concerned with inserting balloon catheter occurred in two cases (1.4 per cent) which were abdominal aortic dissection and laceration of iliac artery. At the present time, the primary indication for IABP is in assistance of the open heart surgical patient. There are three important factors in successfully managing the patients with IABP. First, begin IABP assist as soon as possible if indicated. Second, keep an adequate circulating volume with mean left atrial pressure being maintained around 20 mmHg and cardiac index at 2.1 L/min./M or greater. Third, improve the peripheral vascular circulation, which might need peripheral vasodilator.

Key Words

intra-aortic balloon catheter inability in weaning from cardiopulmonary bypass poor left ventricular function reducing left ventricular afterload augmenting diastolic pressure left atrial pressure improvement of peripheral circulation 


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  1. 1.
    Berger, R.L. and Saini, V.K.: Conversion of nonpulsatile cardiopulmonary bypass to pulsatile flow by intra-aortic balloon pumping during myocardial revascularization for cardiogenic shock,Circulation (Supp. II) 45, 46: 130 (abst.) 1972.Google Scholar
  2. 2.
    Berger, R.L., Saini, V.K., Ryan, T.J., Sokol, D.M. and Keefe, J.F.: Intra-aortic balloon assist for postcardiotomy cardiogenic shock,J. Thor. Cardiovasc. Surg., 66: 906–915, 1973.Google Scholar
  3. 3.
    Bregman, D.: Assessment of intra-aortic balloon counterpulsation in cardiogenic shock,J. Crit. Care Med., 3: 90–93, 1975.CrossRefGoogle Scholar
  4. 4.
    Bregman, D., Parodi, E.N., Edie, R.N., Bowman, F.O., Reemtsma, K. and Malm, J.R.: Intra-operative unidirectional intra-aortic balloon pumping in the management of left ventricular power failure,J. Thor. Cardiovasc. Surg. 70: 1010–1023, 1975.Google Scholar
  5. 5.
    Buckberg, G.D., Towers, B., Paglia, D.E., Mulder, D.G. and Maloney, J.V.: Subendocardial ischemia after cardiopulmonary bypass,J. Thor. Cardiovasc. Surg., 64: 669–684, 1972.Google Scholar
  6. 6.
    Buckley, M.J., Craver, J.M., Gold, H.K., Mundth, E.D., Daggett, W.M. and Austin, W.G.: Intra-aortic balloon pump assist for cardiogenic shock after cardiopulmonary bypass,Circulation (Suppl. III) 47, 48: 90–94, 1973.Google Scholar
  7. 7.
    Corday, E., Swan, H.J.C., Lang, T., Goldman, A., Matloff, J.M., Gold, H. and Meerbaum, S.: Physiologic principles in the application of circulatory assist for the failing heart,Am. J. Cardiology 26: 595–602, 1970.CrossRefGoogle Scholar
  8. 8.
    Kantrowitz, A., Tjonneland, S., Freed, P.S., Phillips, S.J., Butner, A.N., and Sherman, J.L.: Initial clinical experience with intra-aortic pumping in cardiogenic shock,J. A. M.A. 203: 135–140, 1968.CrossRefGoogle Scholar
  9. 9.
    Malm, J.R.: What's new in cardiothoracic surgery,S.G.O. 136: 191–194, 1973.Google Scholar
  10. 10.
    Maroko, P.R., Bernstein, E.F., Libby, P., De-Laria, G.A., Covell, J.W., Ross, J. and Braunwald, E.: Effects of intraaortic balloon counterpulsation on the severity of myocardial ischemic injury following acute coronary occlusion,Circulation 45: 1150–1159, 1972.PubMedGoogle Scholar
  11. 11.
    Moulopoulos, S.D., Topaz, S. and Kolff, W.J.: Diastolic balloon pumping (with carbon dioxide) in the aorta-Amechanical assistance to the failing circulation,Am. Heart J. 63: 669–675, 1962.PubMedCrossRefGoogle Scholar
  12. 12.
    Mundth, E.D.: Mechanical and surgical intervention for the reduction of myocardial ischemia,Circulation (Supp. I) 53: 176–190, 1976.Google Scholar
  13. 13.
    Najafi, H., Henson, D., Dye, W.S., Javid, H., Hunter, J.A., Callaghan, R., Eisenstein, R. and Julian, O.C.: Left ventricular hemorrhagic necrosis,Ann. Thor. Surg. 7: 550–561, 1969.CrossRefGoogle Scholar
  14. 14.
    Pappas, G., Winter, S.D., Kopriva, C.J., and Steele, P.P.: Improvement of myocardial and other vital organ functions and metabolism with a simple method of pulsatile flow (IABP) during clinical cardiopulmonary bypass,Surgery 77: 34–44, 1975.PubMedGoogle Scholar
  15. 15.
    Pappas, G.: Asimple method of producing pulsatile flow during clinical cardiopulmonary bypass,Ann. Thor. Surg., 17: 405–406, 1974.CrossRefGoogle Scholar
  16. 16.
    Parker, F.B., Neville, J.F., Hanson, E.L. and Webb, W.R.: Intraaortic balloon counter-pulsation and cardiac surgery,Ann. Thor. Surg. 17: 144–151, 1974.CrossRefGoogle Scholar
  17. 17.
    Rosenweig, J., Chatterjee, S., Czarnecki, S. and Bernstein, S.: Role of balloon counterpulsation in the “acute coronary” patient,Connecticut Medicine, 38: 54–58, 1974.Google Scholar
  18. 18.
    Sander, C.A., Buckley, M.J., Leinbach, R.G., Mundth, E.D. and Austin, W.G.: Mechanical circulatory assistance-current status and experience with combining circulatory assistance, emergency coronary angiography, and acute myocardial revascularization,Circulation 45: 1292–1312, 1972.Google Scholar

Copyright information

© The Japan Surgical Society 1978

Authors and Affiliations

  • Hiroshi Watanabe
    • 1
  • W. Dudley Johnson
    • 1
  • Richard T. Shore
    • 1
  • Kenneth L. Kayser
    • 1
  1. 1.Milwaukee Heart Surgery AssociatesMilwaukeeUSA

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