Balloon Pump Counterpulsation Part II: Perioperative Hemodynamic Support and New Directions

Abstract

Intraaortic balloon pump (IABP) counterpulsation, introduced more than 50 years ago, remains the most commonly utilized mechanical circulatory support device for patients with cardiogenic shock and myocardial ischemia, despite lack of definitive proof regarding its outcome in these patients. Part I of this review focused on the history of counterpulsation, physiologic principles, technical considerations, and evidence for its use in cardiogenic shock; Part II will discuss periprocedural uses for IABP counterpulsation and review advances in technology, including the emergence of alternative mechanical circulatory support devices that have influenced IABP utilization.

Mechanical circulatory support: complications, outcomes, and future directions

“…At present, IABP is the MCS device most commonly deployed in the descending aorta as a rescue measure for attempts to optimize cardiac pathology. Balloon counterpulsation may provide benefit when used in certain populations, but IABP use for circulatory support remains controversial 56. Emergent technologies that can be deployed in the descending aorta focus on superseding limitations associated with IABP use while retaining the benefits of not requiring intracardiac device placement.…”

Intra-aortic balloon pump counterpulsation: technical function, management, and clinical indications

“…The first reported perioperative IABP use in 1975 was in a patient with post-MI gastric bleeding undergoing an exploratory laparotomy with IABP support 90. Over a dozen case reports have been published since then, detailing IABP support during diverse operations, including lung resections, liver resections, cesarean deliveries, hip replacements, and maxillofacial reconstruction 91…”

“…90 Over a dozen case reports have been published since then, detailing IABP support during diverse operations, including lung resections, liver resections, cesarean deliveries, hip replacements, and maxillofacial reconstruction. 91…”

So You Want to Write a Narrative Review Article?

“…Unfortunately, recent alterations in publishing has allowed for generation of many Narrative Reviews Articles, most without merit. [7][8][9] Having published nine Review Articles [10][11][12][13][14][15][16][17][18] (currently working on numbers ten/eleven), at the risk of sounding trite, I truly believe that passion and pride of the Authors are the two most important factors that determine the quality of a Narrative Review Article. Publishing a Narrative Review Article in a "reputable" Journal (truly peer-reviewed by multiple seasoned/experienced Journal Editors) is an enormous amount of work.…”