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Extra-aortic balloon counterpulsation: an intraoperative feasibility study.

Malcolm E Legget1, William S Peters, F Paget Milsom

  • 1Department of Cardiology, Green Lane Hospital, Auckland, New Zealand. malcolml@adhb.govt.nz

Circulation
|September 15, 2005
PubMed
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The extra-aortic balloon (EAB) offers a safe, non-blood-contacting method for counterpulsation. This innovative approach enhances coronary blood flow and reduces ventricular afterload without complications.

Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Medical Devices

Background:

  • Existing counterpulsation and ventricular assistance methods carry significant risks of vascular and limb complications.
  • A novel non-blood-contacting counterpulsation technique utilizing an extra-aortic balloon (EAB) placed around the ascending aorta was developed.

Purpose of the Study:

  • To evaluate the safety and performance of the extra-aortic balloon (EAB) for counterpulsation.
  • To assess the impact of EAB on coronary blood flow and left ventricular function.

Main Methods:

  • The EAB was applied to six patients undergoing off-pump coronary bypass surgery.
  • Hemodynamic, echocardiographic, and Doppler parameters were measured at baseline and during EAB augmentation (1:2 and 1:1).
  • Safety was assessed by monitoring for complications and changes in heart rate, blood pressure, and transient Doppler signals.

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Main Results:

  • No complications were observed during EAB application and use.
  • Diastolic coronary blood flow increased by 67% with EAB assistance.
  • Left ventricular end-systolic area decreased by 16%, left ventricular wall stress by 31%, and fractional area change improved by 13%.

Conclusions:

  • Extra-aortic balloon (EAB) counterpulsation effectively augments coronary flow and reduces left ventricular afterload.
  • The EAB demonstrates safety and efficacy in a preliminary patient cohort.
  • Further investigation is recommended for potential chronic support applications in heart failure.