Last updated on Mon, 05/14/2018 - 06:02
Highest mark: ?
Outline the indications for and the potential complications of Intra-Aortic Balloon Pump (IABP) insertion.
Indications for IABP insertion include:
• Prophylactic (eg. cardiac surgery left main with unstable angina; or non cardiac surgery with severe Left Ventricular impairment)
• Failure to wean from CPB
• Cardiogenic shock – acute MR/VSD
• Support for re-perfusion/revascularisation
• Bridge to heart transplant
Potential complications include:
• Limb ischemia
• Vascular trauma, dissection
• Balloon rupture
• Malposition, vascular obstruction
• Malfunction, failure to unwrap
In brief summary:
Indications for IABP use:
No choice but pump
- Failure to come off bypass
- Severe ischaemic mitral regurgitation or ventricular septal defect
with haemodynamic compromise, while waiting for repair
Probably harmless, but probably not useful
- High risk CABG patients (pre-op)
- High-risk PCI patients (pre-op)
- Cardiogenic shock while waiting for PCI
- Pulmonary oedema in spite of maximal medical management
- Takotsubo cardiomyopathy
- Neurogenic stress cardiomyopathy of subarachnoid haemorrhage
- Severe aortic stenosis with cardiogenic shock
Complications of IABP use:
- Common complications
- Mild limb ischaemia - 2.9%
- Balloon leak - 1.0%
- Major limb ischaemia - 0.9%
- Haemorrhage - 0.8%
- Leg amputation due to ischaemia - 0.1%
- Rare complications
- Atheromatous cholesterol emboli
- Aortic or arterial dissection
- Cerebrovascular accident
- Helium embolism
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