Initial Clinical Experience With Intraaortic Balloon Pumping in Cardiogenic Shock

TLDR

The study aims to determine whether intraaortic balloon pumping can benefit patients with myocardial infarction without cardiogenic shock and low cardiac output syndromes after open‑heart surgery. The device is a catheter‑mounted balloon inserted through a femoral arteriotomy into the thoracic aorta, with helium‑driven pumping synchronized to the heart by ECG or aortic pressure signals. In this initial experience, balloon pumping improved circulation in two patients (one survived), caused no thrombosis or significant hemolysis, and appears effective despite early deaths and insertion complications.

Abstract

Our intraaortic cardiac assistance system for patients in cardiogenic shock following myocardial infarction consists of a catheter and balloon inserted through a femoral arteriotomy into the thoracic aorta. The pumping chamber, activated by helium, is synchronized with the heart by signals from the electrocardiogram or the central aortic pressure transducer. Pumping improved two patients' circulatory status; one survived. Two patients died before pumping could begin; in another, an abdominal aortic aneurysm prevented insertion of the pump. Thrombosis did not occur during pumping; hemolysis appeared minimal. Although final evaluation must await more data, balloon pumping appears to be effective in cardiogenic shock. Further study may establish a place for the procedure in myocardial infarction without cardiogenic shock and in low cardiac output syndromes associated with open-heart surgery.