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Published on: July 5, 2024
Intra-Aortic Balloon Pump Malposition Reduces Visceral Artery Perfusion in an Acute Animal Model
Maximilian Vondran1, Ardawan J Rastan1, Eugen Tillmann1
1Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany.
Abstract:
Visceral artery perfusion can be potentially affected by intra-aortic balloon pump (IABP) catheters. We utilized an animal model to quantify the acute impact of a low balloon position on mesenteric artery perfusion. In six pigs (78 ± 7 kg), a 30-cc IABP was placed in the descending aorta in a transfemoral procedure. The celiac artery (CA) and the cranial mesenteric artery (CMA) were surgically dissected. Transit time blood flow was measured for (i) baseline, (ii) 1:1 augmentation with the balloon proximal to the visceral arteries, and (iii) 1:1 augmentation with the balloon covering the visceral arteries. Blood flow in the CMA and CA was reduced by 17 and 24%, respectively, when the balloon compromised visceral arteries compared with a position above the visceral arteries (flow in mL/min: CMA: (i) 1281 ± 512, (ii) 1389 ± 287, (iii) 1064 ± 276, P < 0.05 for 3 vs. 1 and 3 vs. 2; CA: (i) 885 ± 370, (ii) 819 ± 297, (iii) 673 ± 315; P < 0.05 for 3 vs. 1). The covering of visceral arteries by an IABP balloon causes a significant reduction of visceral artery perfusion; thus, the positioning of this device during implantation is critical for obtaining a satisfactory outcome.
Insights
Intra-aortic balloon pump (IABP) placement can significantly reduce visceral artery blood flow. Proper IABP positioning is critical to avoid compromising mesenteric artery perfusion and ensure patient safety.
Area of Science:
- Cardiovascular Physiology
- Medical Device Engineering
- Surgical Interventions
Background:
- Intra-aortic balloon pump (IABP) use is common in critical care.
- Potential complications include effects on visceral artery perfusion.
- Quantifying these effects is crucial for safe IABP implantation.
Purpose of the Study:
- To investigate the acute impact of IABP catheter position on mesenteric artery blood flow.
- To quantify the reduction in visceral artery perfusion when the IABP balloon covers these vessels.
Main Methods:
- An animal model using six pigs was employed.
- IABP was inserted via transfemoral approach into the descending aorta.
- Blood flow in the celiac artery (CA) and cranial mesenteric artery (CMA) was measured under different IABP augmentation conditions.
Main Results:
- Covering visceral arteries with the IABP balloon reduced CMA flow by 17% and CA flow by 24% compared to a proximal position.
- These reductions were statistically significant (P < 0.05).
- Baseline CMA flow was 1281 ± 512 mL/min, and CA flow was 885 ± 370 mL/min.
Conclusions:
- IABP balloon coverage of visceral arteries significantly impairs mesenteric artery perfusion.
- Optimal IABP device positioning is essential for successful clinical outcomes.
- Careful consideration of anatomical proximity is vital during IABP implantation.
