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Reducing Perioperative Mortality with the Intra-Aortic Balloon Pump

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Reducing Mortality in the Perioperative Period

Abstract

The intra-aortic balloon pump (IABP) enhances myocardial performance by minimizing oxygen supply/demand mismatch [1–6]. Balloon inflation during diastole enhances myocardial oxygen delivery due to increased diastolic coronary perfusion pressure [4–6]. Balloon deflation just prior to systole reduces myocardial oxygen demand by unloading the left ventricle [4–6]. Recent evidence has identified the IABP as a therapeutic modality that may reduce perioperative mortality due to these myocardial benefits [1–3].

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Author information

Authors and Affiliations

  1. Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Dulles 680, HUP, 3400 Spruce Street, Philadelphia, PA, 19104-4283, USA

    Emily MacKay DO, MD & Aris Sophocles MD

  2. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, I Gustave L. Levy Place, New York, NY, 10029-6574, USA

    George Silvay MD, PhD

  3. Cardiovascular and Thoracic Section, Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Dulles 680, HUP, 3400 Spruce Street, Philadelphia, PA, 19104-4283, USA

    John G. T. Augoustides MD, FASE, FAHA

Authors
  1. Emily MacKay DO, MD
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  2. Aris Sophocles MD
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  3. George Silvay MD, PhD
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  4. John G. T. Augoustides MD, FASE, FAHA
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Corresponding author

Correspondence to John G. T. Augoustides MD, FASE, FAHA .

Editor information

Editors and Affiliations

  1. Anestesia Rianimazione e Terapia Intensiva, Università Vita-Salute San Raffaele Ospedale San Raffaele, Milan, Italy

    Giovanni Landoni

  2. Anestesia Rianimazione e Terapia Intensiva, Università Vita-Salute San Raffaele Ospedale San Raffaele, Milan, Italy

    Laura Ruggeri

  3. Anestesia Rianimazione e Terapia Intensiva, Università Vita-Salute San Raffaele Ospedale San Raffaele, Milan, Italy

    Alberto Zangrillo

Summary Table

Summary Table

Clinical summary

Indications

Contraindications

Complications

Monitoring

Cardiogenic shock

1. Aortic regurgitation

1. Aggravation of aortic regurgitation

Imaging is required to confirm correct placement

High-risk CABG

2. Severe aortic atheroma

2. Atheroembolism

Optimal timing for balloon inflation and deflation in the cardiac cycle maximizes hemodynamic benefits

High-risk PCI

3. Aortic dissection

3. Aortic dissection

Severe myocardial ischemia in noncardiac surgery

4. Aortic aneurysm

4. Arterial rupture

Monitoring for distal ischemia reduces complications

5. Aortic branch vessel occlusion

5. Aortic branch vessel occlusion

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MacKay, E., Sophocles, A., Silvay, G., Augoustides, J.G.T. (2017). Reducing Perioperative Mortality with the Intra-Aortic Balloon Pump. In: Landoni, G., Ruggeri, L., Zangrillo, A. (eds) Reducing Mortality in the Perioperative Period. Springer, Cham. https://doi.org/10.1007/978-3-319-46696-5_10

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  • DOI: https://doi.org/10.1007/978-3-319-46696-5_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46695-8

  • Online ISBN: 978-3-319-46696-5

  • eBook Packages: MedicineMedicine (R0)

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