Mechanical problems in the use of the intra-aortic balloon

Although there are many complications in the use of the intraortic balloon (IAB) support device, they are relatively benign compared to the benefits of the device. The purpose of this paper is, firstly, to review a protocol in the safe use of this device, and secondly to remind enthusiastic users of the IAB that the use of this method is not always as benign as we would like it to be. Rarely reported findings at postmortem examination in two patients who died in cardiogenic shock are described. The aorta of one of the two cases in this report had a longitudinal tear which involved only the intima and extended from the common femoral artery to well above the renal arteries. In the second case, the balloon tip had entered at the bifurcation of the aorta in a subintimal manner and had re-entered well below the renal arteries, to be relocated in the proper site in the descending aorta.