Intra-Aortic Balloon Pump - Indication, Procedure, and Risks

Introduction

IABP, or intra-aortic balloon pump, is a therapeutic cardiovascular device that helps the heart pump blood. If the heart is not able to pump a sufficient amount of blood for the body, an intra-aortic balloon pump is suggested. The intra-aortic balloon pump includes several parts- a thin and highly flexible tube, the catheter, and a long balloon attached at the very tip of the catheter- called an IAB or an intra-aortic balloon. The opposite end of the catheter is connected to a computer monitor. With a mechanism of inflating and deflating the balloon only at the proper and required time or only when the heart beats.

How Does the Intra-Aortic Balloon Pump Work?

• The heart pumps oxygen-rich blood with every nutrient for all body parts. Blood then leaves the heart via the arteries, also called the blood vessels, which carry oxygen-rich blood. The outer membrane of the heart is also covered with arteries. These arteries that envelop the cardiac walls or the heart walls are called coronary arteries. Through the coronary vessels, the heart can receive all the oxygen along with the nutrients it requires.

• When the heart contracts, blood is moved out to the body. As the heart relaxes, blood easily flows into the coronary blood vessels to bring back oxygen and nutrients to the heart. An intra-aortic balloon pump allows the blood to flow in a more manageable manner into the coronary arteries. This additionally helps the heart in pumping more and more blood with every contraction that takes place.

• The balloon is then smoothly inserted into the aorta, the largest artery leaving the heart. In several cases, this procedure is done after a tiny cut is made on the inner side of the upper part of the leg. The respective healthcare provider will eventually insert the balloon pump catheter inside a selected artery within the leg and guide the same into the aorta.

• From there, the intra-aortic balloon can start to perform its necessary function efficiently. The intra-aortic balloon is later set to inflate as and when the heart relaxes. The balloon pushes the blood flow backward toward the heart’s coronary arteries. The coronary arteries may not receive enough blood without the intra-aortic balloon pump.

• When the heart starts to contract, the balloon slowly deflates, allowing the heart to smoothly pump more blood to the body while using minimal energy. The intra-aortic balloon pump continues the process of inflation and deflation until the healthcare provider has removed it.

When Is an Intra-Aortic Balloon Pump Suggested?

Intra-aortic balloon pump therapy or mechanism is generally used to treat a cardiogenic shock. A cardiogenic surprise is when the heart is not able to pump enough amount of blood to equalize the requirements of the body. Mentioned below are a few conditions that lead to using an intra-aortic balloon pump as a treatment modality.

• Unstable angina (a condition characterized by chest pain or discomfort that occurs at rest or with minimal exertion).

• Myocardial infarction (heart attack).

• The abnormal rhythm of the heart.

• Heart failure.

• Profuse sweating in the forehead, scalp, and palms.

• Feeling dizzy and lightheaded.

• Shortness of breath.

• Uncomfortable overall pressure similar to getting squeezed.

• Congenital heart anomalies.

• Percutaneous coronary intervention.

• Heart surgery.

• Aortic aneurysms (abnormal bulges or ballooning of the aorta, the body's main artery).

• Cardiogenic shock (a severe condition in which the heart fails to pump enough blood to meet the body's demands).

What Are the Risks Involved in an Intra-Aortic Balloon Pump?

Intra-aortic balloon pump is a very successful and highly advised treatment strategy, still, as with all the treatment and management modalities, an intra-aortic balloon pump involves little risk, which can be easily avoided. Mentioned below are a few risks involved in the treatment with an intra-aortic balloon pump.

• Damage to the blood vessels.

• A lack of blood flow to the lower limbs.

• Injury to a specific artery.

• Rupture of the balloon.

• Incorrect position of the balloon.

• An injury to the kidneys.

• Peripheral vascular disease.

• Low platelet count.

• Increased clotting time.

• Infection.

• Stroke.

• Chest pain.

• Tingling sensation in the legs.

• Pale skin.

• Bleeding at the site of insertion of the catheter.

How Does One Prepare for Intra-Aortic Balloon Pump Therapy?

An intra-aortic balloon pump therapy, being a scheduled procedure, requires a little preparation from the patient's end. Mentioned below are a few of the procedure preparations for an intra-aortic balloon pump treatment that must be considered from the patient’s end.

• The respective healthcare provider will explain the entire procedure in great detail.

• The patient is free to ask any kind of question or query about the procedure before, after, or during the process.

• Generally, a medical consent form is signed after the patient reads the document thoroughly.

• Fasting before an intra-aortic balloon pump treatment varies from patient to patient and from case to case, where the healthcare provider is the best person to decide how long to fast and if fasting is required for the particular patient or not.

• Patients who are perhaps pregnant or are planning to get pregnant must inform the healthcare provider regarding the same.

• A known allergy to latex and Lidocaine or any kind of drug such as local anesthetic.

• The patient is also expected to describe any medications or herbal supplements they are on.

• The presence of any underlying medical disease, especially those related to the blood and cardiovascular system, must be informed to the doctor along with all the medical history.

• The healthcare provider may suggest tests such as a complete blood picture, electrocardiogram, x-rays of the chest, and an echocardiogram before the treatment begins.

Conclusion

An intra-aortic balloon pump or IABP is a cardiovascular device that helps in the efficient and smooth flow of blood in a heart that cannot pump the required amount of blood to the body due to an underlying cardiovascular condition or an anomaly. Chest pain after the treatment is a sign of slight adjustment of the device, but it must be reported to the respective healthcare provider in case the patient feels discomfort. An intra-aortic balloon pump is a highly successful treatment modality, and the patient always has a positive outcome and outlook on life after the therapy is over.