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The Intra-Aortic Balloon Pump
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Perioperative use of the intra-aortic balloon pump: where do we stand in 2018?

Kay Maeda, Shuichiro Takanashi1, Yoshikatsu Saiki2

  • 1Division of Cardiac Surgery, Sakakibara Heart Institute, Tokyo, Japan.

Current Opinion in Cardiology
|October 11, 2018
PubMed

Insights

Intra-aortic balloon pump (IABP) use shows no mortality benefit for cardiogenic shock post-myocardial infarction. However, perioperative IABP offers benefits for high-risk revascularization patients, with new technology improving outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Critical Care

Background:

  • The intra-aortic balloon pump (IABP) is a widely used device for circulatory support in cardiogenic shock.
  • Recent clinical trials have not demonstrated evidence-based clinical benefits of IABP support in terms of mortality.
  • This review focuses on the current outcomes and challenges associated with perioperative IABP use.

Purpose of the Study:

  • To review the current outcomes and challenges of perioperative intra-aortic balloon pump (IABP) use in patients with cardiogenic shock.
  • To evaluate the clinical utility of IABP in specific patient populations and explore technological advancements.

Main Methods:

  • Literature review of recent clinical trials and technological developments concerning perioperative IABP use.
  • Analysis of IABP's impact on mortality in cardiogenic shock and its benefits in high-risk surgical patients.
  • Examination of new IABP technologies, including optical fiber sensors.

Main Results:

  • IABP support did not significantly reduce mortality in myocardial infarction complicated by cardiogenic shock.
  • Perioperative IABP use demonstrated beneficial clinical outcomes for high-risk patients undergoing coronary revascularization.
  • Advanced IABP technology with optical fiber sensors shows promise in improving hemodynamics and reducing complications.

Conclusions:

  • Perioperative IABP use is considered reasonable for cardiogenic shock patients as a bridge to surgical intervention, cardiopulmonary bypass weaning, and postoperative recovery.
  • Future research, including larger and longer-term clinical investigations, is needed to define optimal patient selection and the definitive role of IABP therapy.
  • Revolutionary technological advancements are anticipated to enhance IABP therapy limitations.
Abstract

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