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Transcript
INTRA AORTIC BALLOON PUMP
By: ABDULRAHMAN ALSALMI
CHIEF CARDIAC PERFUSIONIST
KFMMC
• The Perfusion department has different machines
for different functions:
– Heart lung machine . Which is used for open heart
surgery .
– VAD
– ECMO
– CPS
– IAPB
Intra Aortic Balloon Pump
• Intra Aortic Balloon Pump is a cardiac assist
device which provides temporary circulatory
support .
• It supports the heart’s left ventricle by
increasing coronary perfusion while reducing
left ventricular work.
• Coronary perfusion is increased by
augmenting ( increasing ) blood pressure
during the diastolic phase of the cardiac
cycle.
Countrepulsation is the active process of mechanically
displacing intra aortic blood by inflating and deflating
opposite to the heart’s activity. This is were it gets the
name .
The IAB System is comprised basically of two entities:
1. Balloon.
2. Console.
The intra aortic balloon comes in various sizes and designs.
However, they all function to displace blood from the
aorta.
The balloon functions by inflating and deflating with specific
driving gas.
• The various balloon use either carbon dioxide or
Helium as the inflating gas.
• Atmospheric air can also be used to inflate the
balloon , but is rarely used .
• There are specific reasons for using carbon
dioxide and helium .
• Carbon dioxide is eighteen times more soluble in
blood than air and fourty times more soluble than
helium .
1. The bidirectional balloon .
2. The unidirectional balloon .
Arrow
ACAT1+
• There are three
manufactured ( IABP )
console .
– 1. Arrow (Bard, Kontron, Datascope
Cardiac Assisst-BSC )
– 2. Datascope
– 3. Smec
Placement of IAB
Inflate During
Diastole
Increase Coronary Perfusion
Deflate During
Systole
Decrease Afterload
• Diagrammatic representation of average timing of
electrical and mechanical events on both sides of the
heart during atrial and ventricular systole in normal
subjects .(1) Onset of right atrial contraction,(2) onset of
left atrial contraction , (3) onset of left ventricular
contraction, (4) onset of right ventricular contraction,
(5) onset of right ventricular ejection , (6) onset of left
ventricular ejection , (7) end of left ventricular ejection ,
(8)end of right ventricular ejection . Striped areas
represent ventricular isometric contraction .
1.Refractory ventricular failure .
2.Cardiogenic shock .
3.Unstable angina .
4.Impending infarction .
5.Mechanical complication due to a cute
myocardial infarction ,i.e, VSD , MV
regurgitation or papillary muscle rupture .
6.Septic shock .
7.Weaning from cardiopulmonary by pass .
8.Support and stabilization during coronary
angiography and angioplasty .
9.Intra operative pulsatile flow generation .
10.Prior to Heart Transplant.
1. Sever aortic insufficiency .
2. Abdominal or aortic aneurysm .
3. Sever calcific aortic – iliac disease or
peripheral vascular disease .