Life saving procedures for cardiovascular diseases-Intra-aortic cardiac balloon pump - indications ,contraindications ,complications and physiologic effects

PHYSIOLOGIC EFFECT OF INTRA-AORTIC BALLOON PUMP THERAPY

After proper placement of the IAB in the descending aorta with it `s the tip of the distal aortic arch (below the origin of the left subclavian artery) the balloon is connected to a drive console . The console itself is composed of a tank of gas under pressure, an ECG monitor and record the pressure waves, the timing adjustments for inflation / deflation, the election and battery switches sources backup power. 

The gases used for inflation is either helium or carbon dioxide. The advantage of helium is its lower density and therefore a better rapid diffusion coefficient. Whereas carbon dioxide has increased solubility in blood and therefore reduces the potential impact of gas embolisering after a burst balloon. Inflation and deflation are synchronized with the cardiac cycle of the patient. Inflation in the early results of diastole in the proximal and distal displacement of blood volume in the aorta. Deflation occurs just prior to the onset of systole.

INDICATIONS AND CONTRAINDICATIONS

According to early indications for intraaortic balloon pump has included cardiogenic shock or left ventricle, unstable angina, non-separating a patient from cardiopulmonary bypass and prophylactic applications, including stabilization of preoperative patients with cardiovascular and stabilization of preoperative noncardiac surgical patient. Today, more than the extension of the following: cardiac patients requiring procedural support during coronary angiography and PTCA, or as a bridge to cardiac transplantation. Later in pediatric cardiac patients and patients with stunned myocardium, myocardial contusion, septic shock and drug-induced cardiovascular failure, IABP can save lives.

Intra Aortic Balloon Pump therapy should be considered for use in patients who have the potential recovery of left ventricle, or support patients awaiting a heart transplant. Contra-indications of IABP are relatively rare. There are reports of successful use in patients with aortic insufficiency and in patients with acute trauma of the descending aorta.

COMPLICATIONS

Since the device is placed in the femoral artery and aorta may cause ischemia, and compartment syndrome. The biggest risk is the leg supplied by the femoral artery may be ischemic, but the position of the balloon for distal aortic arch can cause occlusion of the renal artery and kidney failure later. Other complications include cerebral embolism during insertion, infection, dissection of the aorta or iliac artery, perforation of the artery and bleeding in the mediastinum. Mechanical failure of the balloon itself is also a risk involved in vascular surgery to remove in this circumstance. After removing the balloon, there is also a risk of embolic shower "micro clots that have formed on the surface of the ball, and can lead to thrombosis device, myocardial ischemia, hemodynamic decompensation and late pseudoaneurysm.