Intra-Aortic Balloon Pumps
( IABP’s)
© D. J. McMahon 2014
rev 141110
Two definitions:
Essentials of operation –
> A balloon is introduced thru a sheath, entering the
femoral artery, and up into the descending aorta.
> The balloon is rapidly inflated just after the peak of
ventricular pressure, so that a back-pressure is
created in the ascending aorta. This achieves two
things:
1) it increases blood flow to the coronary arteries,
2) it decreases afterload on the heart.
Balloon inflation is triggered by either the R-wave of
the ECG, or by the peak arterial pressure signal.
Essentials of operation, cont’d –
> The balloon is deflated when the arterial pressure
has decreased to near the diastolic value.
Helium is used to pump the balloon, due to its light
weight and because it poses no threat to the patient
if it leaks into the vessal.
The helium ‘shuttles’ back and forth, and is not
consumed. Ideally, the system will be tight enough
so that no helium is lost.
http://www.bing.com/videos/search?q=Intra-Aortic+Balloon+Pump+Video&view=detail&mid=E3DA94D633AF2BFDB111E3DA94D633AF2BFDB111&first=0&FORM=LKVR6#view=detail&mid=793FF2151275ABFBD536793FF2151275ABFBD536
http://www.bing.com/videos/search?q=intra+aortic+balloon+pump+counterpulsation&view=detail&mid
Back-pressure increases
blood flow to the coronaries
Effect of counterpulsation (point D) by the IAB
on the normal pressure waveform (dotted line).
Indications for the IABP –
- Serious myocardial infarction
- pre-surgical support
- Supporting a patient after open heart surgery
- most common use
- Pre-transplant candidates
- minimizes load on a failing heart
NB:
http://www.datascope.com/products/balloons/sensation-plus/gallery/video/
Why use helium in the balloon?
Densities:
(@ 0° C)
O2:
air:
He:
H2:
1.429 g/L
1.292
0.1786
0.0899
Helium delivery system, Arrow AutoCAT2 balloon pump
Datascope model 97
(mid-’80s to late ‘90’s)
Datascope model 97
> Manual control of timing
> Less information on the
LCD display
Major Players in Balloon Pumps:
-- Arrow-Teleflex Corp:
‘AutoCat-2 Wave’
~125,000 balloons are placed
each year worldwide
See http://www.arrowintl.com/products/videos/ATC2-CD/default.asp
Arrow AutoCat 2
Arrow AutoCat 2 WAVE
Major Players in Balloon Pumps:
Maquet (Datascope) Corp:
(ma-KAY)
model CS300
Maquet’s “Cardio Save”
Flow Diagram of the Maquet CS100 IABP
Block diagram of the Maquet CS100 IABP
Biomed Maintenance of Balloon Pumps –
Training thru manufacturer service schools
Service intervals based on a “power-on” timer
- Checking of timing and input signal circuits
- Verifying alarm functions
- Replacing seals and gaskets in the
helium gas supply
- Verifying a tight helium gas supply
- Verifying battery age & competence
Simulators for IABP’s –
Fluke MedSim 300B
(discontinued)
Manufacturers will provide their own for
training biomed techs and clinical staff.
Left Ventricular Assist Device (LVAD) :
External Cardiac Assist Devices: