An intra-aortic balloon pump is a temporary treatment to help the heart pump enough blood around the body, which people with certain heart conditions may require.
An intra-aortic balloon pump (IABP) consists of a thin tube and balloon that a doctor inserts into an artery leaving the heart. The inflation and deflation of the balloon pump help increase blood flow from the heart.
People may need an IABP if they have cardiogenic shock. This can occur as a result of certain heart problems, such as heart attack or heart failure. Cardiogenic shock means the heart is unable to pump enough blood and oxygen to vital organs in the body.
This article explains how an IABP works, who might need one, the risks and benefits of an IABP, and recovery.
An IABP is a device that supports the heart in pumping enough blood to the body.
An IABP is a flexible, thin tube with a long balloon attached to one end. The other end of the tube, or catheter, attaches to a computer that controls when the balloon inflates or deflates.
A doctor inserts the IABP into the aorta. The aorta is a large artery that transports blood away from the heart to supply the rest of the body.
The balloon inflates and deflates in time with each heartbeat, which increases the amount of blood the heart is able to pump.
When functioning normally, the heart contracts and pumps out oxygenated blood and nutrients to the body. When the heart relaxes, oxygenated blood and nutrients flow toward the heart.
When the heart relaxes, the IABP inflates and increases blood flow toward the heart. When the heart contracts, the IABP deflates and increases blood flow to the rest of the body.
An IABP increases blood flow to and from the heart while lessening the amount of energy the heart has to expend.
Before a doctor places an IABP, they will administer an anesthetic to reduce pain and discomfort during insertion. If a person is receiving an IABP in general surgery, a surgeon may use general anesthesia.
A surgeon makes a cut into an artery in the upper leg to insert the IABP. Using X-ray imaging to guide the catheter, they then thread the IABP up into the aorta by the heart.
A computer, attached to the other end of the catheter, then programs the IABP to inflate and deflate in time to when the heart relaxes and contracts.
Throughout the procedure, a healthcare team will monitor a person’s vital signs, such as heart rate and blood pressure.
After the procedure, people may experience some chest pain, but this usually resolves within a few minutes.
A person may need an IABP if they have cardiogenic shock, which can occur from a variety of heart conditions, such as:
- heart attack
- unstable angina
- heart failure
- heart defects
- certain arrythmias, which are abnormal heart rates or rhythms
Other conditions that
- acute congestive heart failure with low blood pressure
- to prevent or assist with percutaneous coronary intervention, a treatment to open clogged arteries
- heart attack with decreased left ventricular function, resulting in low blood pressure
- coronary artery bypass graft surgery that results in low cardiac output
- as a bridge treatment before people have more permanent treatment, such as a heart transplant
An IABP may not be suitable for people with:
- an unmanaged bleeding condition
- uncontrolled sepsis
- aortic valve regurgitation, which occurs when the heart valve does not close properly
- a tear in the inner layer of the aorta
- a bulge or enlargement in the aorta
- severe peripheral artery disease, unless there is prior treatment with a stent
People may have an IABP in place for several days, during which people will have to stay in the hospital for monitoring.
During this time, a healthcare professional may alter the IABP to inflate and deflate less frequently, or temporarily stop the pump, to see how the heart responds. If the heart is able to pump efficiently by itself, a healthcare professional may remove the pump.
People may also stop IABP treatment if another more permanent treatment is available, such as a heart transplant.
To remove an IABP, a doctor first gives a person an anesthetic or sedative to relax them and numb sensations. The doctor then removes the IABP from the body through the same route they inserted it. They then close the small cut in the upper leg.
Following IABP treatment and removal, people will need to follow any instructions from a healthcare professional about aftercare or further treatment.
Risks of an IABP treatment may vary for each person, depending on their age, overall health, and existing medical conditions. Possible risks of IABP treatment may include:
- infection
- a tear in the balloon
- incorrect positioning of the IABP, which may cause problems such as damage to the kidneys
- restriction of blood flow to a limb that can cause damage, which may be a higher risk for people with peripheral vascular disease
- injury to an artery
- low levels of platelets in the blood, which can prevent the blood from clotting as normal and may lead to excessive bleeding
- stroke
The rate of major complications for IABPs is
An IABP is a catheter with a long balloon attached to one end. A doctor inserts the catheter into the main artery leading away from the heart.
The balloon inflates and deflates in time to the pumping action of the heart, which increases blood flow.
People may require an IABP if the heart is unable to pump enough blood to the body by itself. This can occur from certain heart conditions, such as heart attack or heart failure.
In some cases, an IABP may be lifesaving. IABPs do have some risks, such as infection, incorrect positioning, or bleeding complications.
An IABP is a temporary treatment. A doctor removes the IABP once the heart is able to pump enough blood by itself, or until people are able to have a more permanent treatment option.