ABC Heart Fail Cardiomyop 2022; 2(2): 206-208
Use of Intra-Aortic Balloon Pump in Cardiogenic Shock Associated with Advanced Heart Failure: An Outdated Strategy?
Ciro Mancilha Murad
, Sandrigo Mangini
The use of an intra-aortic balloon pump (IABP) was first described in the 1960s., It is a short-term circulatory assist device that uses helium gas for inflation of a balloon positioned in the descending aorta during diastole and active deflation during systole. The most evident hemodynamic effects are increased coronary perfusion, reduced left ventricular afterload, and an increase in cardiac output by 0.5 to 1 L/min., Due to its greater availability, lower cost, easy implantation, and low complication rates, IABP quickly became the most used percutaneous device in cardiogenic shock. Nevertheless, in spite of the advantages described and the extensive clinical experience, there are still some controversies in relation to its use.
The randomized IABP-SHOCK II Trial evaluated the use of IABP versus clinical treatment in patients with post-acute myocardial infarction (AMI) cardiogenic shock. In this study, the use of IABP did not reduce the primary endpoint of 30-day mortality or the relevant secondary outcomes, and, from then on, the use of IABP in post-AMI cardiogenic shock started to be discouraged by guidelines, with class III, level of evidence B for routine use (not recommended)., It is, however, noteworthy that other devices that provide greater hemodynamic support compared to IABP have also not shown a benefit in increasing survival in post-AMI cardiogenic shock.
[…]
1,305
