INTRAAORTIC BALLOON PUMP SUPPORT DURING HIGH-RISK CORONARY ANGIOPLASTY

Intraaortic balloon pump support has been demonstrated to be of clinic al benefit when used therapeutically and prophylactically in high-risk patients undergoing percutaneous transluminal coronary angioplasty (P TCA). Afterload reduction and post-PTCA-enhanced coronary blood flow a fforded by diastolic augmentation during intraaortic balloon pumping p rovides hemodynamic stabilization, attenuates clinical perturbations o f myocardial ischemia, and may provide an important 'bridge' to emerge nt coronary bypass surgery following abrupt vessel closure complicatin g PTCA. Recent studies demonstrate a reduction in cardiac morbidity an d improved coronary artery patency among patients receiving prophylact ic intraaortic balloon pumping after establishing infarct artery reper fusion during acute cardiac catheterization for acute myocardial infar ction. A modest increase in cardiac output (20-30%), the requirement o f a stable, regular cardiac rhythm, peripheral vascular disease and ao rtic insufficiency limits the use of intraaortic balloon pump support in relatively few patients. These studies demonstrate that intraaortic balloon counterpulsation provides an effective and safe form of mecha nical support in many high-risk patients undergoing PTCA.