From November 1981 to November 1982, intra-aortic balloon pumping (IABP) was used after surgery in eight patients who were from 6 weeks to 6 years old and who weighed from 4.2 to 16.2 kg. In seven patients, specially constructed intra-aortic balloons with 2.5 and 5.0 ml volumes mounted on No. 5F catheters were used. In the largest and oldest patient, a two-chamber 10 ml balloon was used. The pumping module used was the Datascope System 82. Effective diastolic augmentation of arterial pressure was accomplished in seven of the eight patients and suprasystolic diastolic augmentation was accomplished in four. The two youngest and smallest patients are the only long-term survivors. There were two short-term survivors who died 5 and 10 days after successful IABP. In only one patient was there no appreciable effect of IABP. Miniaturization of the equipment has permitted IABP to be used effectively in pediatric patients. Circulation 68, No. 5, 1095-1100, 1983.INTRA-AORTIC BALLOON PUMPING (IABP) has become a standard mode of treatment for perioperative low cardiac output syndrome and cardiogenic shock after myocardial infarction in adults. 1-' However, IABP has been used little in children. The only report of the use of IABP in children suggests that it is not successful in those who are under 5 years of age.4 Our experience with both in vitro and in vivo testing of small balloon catheters in small animals with three different pumping modules convinced us that this valuable method of circulatory support could be used in children.5'6 This report describes our initial experience in eight patients who underwent IABP after open heart surgery.
Materials and methodsAll eight patients had previously undergone open heart surgery for correction of the lesions listed in table 1. All balloon catheters were introduced by cutdown through the common femoral artery with a side-arm Dacron graft. Introduction of the balloon catheters was accomplished in the operating room in two patients and in the intensive care unit in six patients. All the catheters were connected to the Datascope System 82 pumping module modified with a pediatric volume-limiting chamber. The catheter position was checked by chest x-ray to confirm that the tip of the catheter was adjacent to the origin of the left subclavian artery. of pharmacologic support had failed to improve the patients' low cardiac output syndrome (table 1). A two-chambered 10 ml balloon was used in the first and largest patient. In all others either a 2.5 or 5.0 ml volume balloon was used. These balloons were mounted on a No. SF catheter and were specially manufactured by Datascope Corporation. The 2.5 ml balloon has an 8.0 mm diameter and is 10.5 cm in length while the 5.0 ml balloon has a diameter of 10.0 mm and is 13.0 cm long (figure 1). The electrocardiograph was used for triggering the inflation and deflation of the balloon and adjustments were made for inflation and deflation time to permit optimal alteration of the patient's pulse contour (usually from the right radial artery)....