What you need to know about:

Intra-Aortic Balloon Pump (IABP)

Fast Fact

99%
Worth It Rating
Average Cost:
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Recovery Period:
Several days
Permanence:
Depends on patient condition.
177
Doctors
Time it takes:
2-4 hours
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Hospitals & Clinics
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Anesthetize:
General anesthesia

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Overview of

Intra-Aortic Balloon Pump (IABP)

in Thailand

The intra-aortic balloon pump (IABP) is a mechanical device that improves the function of the left ventricle, which helps the heart pump blood. It is a long, thin tube (catheter) with a balloon on the end of it that is inserted into the aorta, the body’s largest artery. The balloon inflates and deflates with the rhythm of your heart. The left ventricle is the chamber that pumps blood into your aorta. An intra-aortic balloon pump inflates when your left ventricle has finished contracting. This helps increase blood flow to the rest of the body. As the left ventricle is about to pump out blood, the balloon deflates, creating extra space in the aorta for more blood to be pumped out. This decreases the workload on the heart. The intra-aortic balloon pump may be indicated for the following patients with appropriate preparation: Patient with coronary artery graft. Patient with coronary artery aneurysm. Patient with aortofemoral graft.

Goals of

Intra-Aortic Balloon Pump (IABP)

An IABP can performed in patients who have the following conditions: Acute mitral valve regurgitation. Severe heart failure. Failure to wean from cardiopulmonary bypass. Cardiogenic shock. Acute heart attack. Support during high-risk percutaneous transluminal coronary angioplasty, rotablator procedures, and coronary stent placement. Support for high-risk patients during other types of surgery, as determined necessary by the doctor.

Price of

Intra-Aortic Balloon Pump (IABP)

Average Cost

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Price Range

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Pros and cons of

Intra-Aortic Balloon Pump (IABP)

Pros

-Reduces cardiac work by decreasing afterload

-Increases coronary blood flow

Cons

N/A

How It Works:

Intra-Aortic Balloon Pump (IABP)

Before inserting the catheter the doctor will clean the insertion site and then administer a local anesthetic. The doctor will insert the catheter into an artery (the femoral artery is pictured here) and thread it into the left side of the heart and the subclavian artery. The other end of the catheter will be in the artery close to the kidney. An imaging study of the lung would show the tip of the catheter between the second and third rib. The length of the catheter will depend on the height of the patient to prevent blockage of the blood vessels at both places. The balloon will set to compress and expand according to the rhythm of the heart and these contractions will move blood from the heart. Helium gas is used to control the pressure of the balloon and it will function when the heart relaxes.

Preparation before

Intra-Aortic Balloon Pump (IABP)

Pre - treatment

Before your procedure, talk with your healthcare provider about all your concerns. He or she will give you detailed instructions. Be sure to tell your healthcare provider if you are pregnant or think you could be. Also let him or her know if you have: -Any other medical conditions -A problem with sedation -New symptoms, such as a sudden fever -If you smoke, you should try to stop before your procedure. It will help reduce your chance of complications. You should also not eat or drink anything after midnight before the day of your procedure. You may also need to stop taking any medicines. Before and during the treatment, you will probably need to take medicine to help prevent blood clots. You may need other tests to assess your health beforehand. These might include: -Basic blood work (to assess for anemia and infection) -An electrocardiogram (to check your heart rhythm) -A chest X-ray (to view your heart and lungs) -An echocardiogram (to view how well your heart is pumping)

Recovery after

Intra-Aortic Balloon Pump (IABP)

Post - treatment

The nurse will assess the function of your heart by monitoring your vital signs, carrying out an electrocardiogram (EKG), and evaluating your urine every hour. If any abnormalities are found, your doctor will be notified immediately to treat the problem. The nurse will teach you how to detect any complications, such as bruising of your hands and feet, infection, and blood clots. The nurse/doctor will assess and monitor the function and settings of the machine by noticing the values displayed on the balloon pump console and follow-up x-rays to ensure proper position. You will be advised not to bend the leg where the catheter is inserted. If you are unable to cooperate, your leg may be tied in place or the doctor may administer sedatives to keep you calm. The intra-aortic balloon pump will only temporarily support the function of your heart. The machine will slowly be withdrawn when your heart’s function improves, as evaluated by your medical team.

Risks & side effects

-Transient loss of peripheral pulse

-Limb ischemia

-Blocked blood vessels

-Damage to the aorta

-Injury to the blood vessels

-Infection

-Damage to the balloon

-Low platelets or damage to red blood cells

-Impact on other organs (such as brain, kidney) due to cardiac tamponade

FAQs:

Intra-Aortic Balloon Pump (IABP)

How does an IABP work?

The IABP reduces the workload on your heart, allowing your heart to pump more blood. The IABP is placed inside your aorta, the artery that takes blood from the heart to the rest of the body. The balloon on the end of the catheter inflates and deflates with the rhythm of your heart. This helps your heart pump blood to the body.  The IABP improves the function of only your left ventricle, since this is the chamber that pumps blood into your aorta. Here's how an IABP works:  After your left ventricle has finished contracting, the balloon inflates. This inflation helps increase blood flow to the heart and the rest of the body. As your left ventricle is about to pump out blood, the balloon deflates. This deflation creates extra space in the aorta, allowing the heart to pump out more blood. This decreases the workload on the heart.

Why might I need intra-aortic balloon pump therapy?

IABP therapy is used to treat cardiogenic shock. That’s when your heart can’t pump enough blood to meet the needs of your body.  Some heart problems can cause cardiogenic shock. These include:  -Unstable angina -Heart attack -Certain abnormal heart rhythms -Heart failure -Heart defects  You may also need an IABP if you have a certain medical procedure. For example, you may need it if you have a percutaneous coronary intervention. This procedure opens a blocked artery in the heart. You also might benefit from an IABP if you have heart surgery.

What are the travel recommendations for before and after the procedure?

Before the Procedure: You should plan to stay in Thailand for at least two weeks through the duration of your treatment. It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure or from the day of the procedure to the day of your follow-up appointment.  

After the Procedure: At your follow-up appointment you will undergo a physical examination and your wound will be checked. You will receive documentation regarding your surgery or procedure and all other relevant documentation for traveling. Avoid activities that require strenuous pulling, pushing, shoving, or lifting as well as kneeling. These can cause bleeding from the injection site at the groin. Keep the injection site at the wrist or groin dry and clean until it is fully healed. Please let the doctor know if you experience redness, swelling, and/or severe pain. If the bleeding does not stop, please place pressure on the site and talk to your doctor immediately.

When traveling by air, if you are seated in Economy Class, please choose an exit row or bulkhead seat for convenience in getting up and moving around every 15-30 minutes. Flex your ankles regularly to prevent deep vein thrombosis. Please take all medication prescribed by your doctor. Carry the appropriate dosage of mediation in your carry-on luggage when you travel as well as a few extra doses in case of an emergency. Carry the prescription for all your medication to avoid problems at the airport.

What happens after IABP therapy?

You may need to stay on the pump for several days. Your healthcare provider will monitor you. He or she may temporarily turn the pump off to see how you respond. Or he or she may set it to inflate and deflate with only every 2nd or 4th heartbeat. If your heart continues to pump well on its own, you may be ready to stop the IABP therapy. You might also stop the therapy when another intervention becomes available (like a donated heart).  When it is time to remove the pump, you will likely receive medicine to help you relax. Your healthcare provider will then remove the catheter and the attached balloon. He or she will also close up the incision on your leg.  Your healthcare provider may give you additional instructions about what to expect. Follow these carefully to help increase your chances of a positive outcome.

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Prima Lertudomkitpisan
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M.D.
Wasan Udayachalerm
Cardiology
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