THE USE OF INTRAAORTIC BALLOON COUNTERPULSATION AS AN ADJUNCT TO REPERFUSION THERAPY IN CARDIOGENIC-SHOCK

Modern coronary care unit interventions have not reduced the high mort ality rate associated with cardiogenic shock due to acute myocardial i nfarction. Results with thrombolytic therapy have also been disappoint ing because of poor infarct artery patency rates in a low coronary flo w state. Percutaneous transluminal coronary angioplasty appears to be a beneficial intervention, but the technique is not available at most hospitals. Intraaortic balloon counterpulsation provides temporary hem odynamic and clinical improvement in the majority of patients with car diogenic shock. The use of intraaortic counterpulsation to augment pat ency rates with thrombolytic therapy or to stabilize patients for tran sfer to a hospital with angioplasty services appears to be a promising strategy for hospitals without an interventional cardiac catheterizat ion laboratory. (C) 1998 Elsevier Science Ireland Ltd.