Technique for insertion of the intra-aortic balloon through the aortic arch

A technique for rapid insertion of the intra-aortic balloon (IABP) through the proximal portion of the aortic arch is described. This method is beneficial in patients who require balloon support but in whom extensive aorto-femoral disease prevents the usual retrograde insertion. In these circumstances the balloon is inserted in the proximal aortic arch because multiple proximal vein grafts, ascending aorta replacement, and aortic valve surgery may make the ascending aorta an unsuitable site. The technique has been used in four patients with benefit sufficient to permit coronary artery bypass grafting with survival.