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Intra-aortic Balloon Counterpulsation Pump

GENERAL INFORMATION:

What is an intra-aortic balloon counterpulsation pump? An intra-aortic balloon counterpulsation pump is also called IABP. It is a device used to treat severe (very bad) heart failure and some other heart problems. The pump has a thin flexible and inflatable catheter (tube) with a balloon on its end. It also has a gas container and a device that inflates (fills) and deflates (empties) the balloon. Monitors to see how the heart is working may be connected to the pump. The IABP is used for a short period of time to help your heart work normally. It lets more blood into your heart, and allows more blood to be pumped out to the rest of your body.

How does my heart work? Your heart has four chambers (rooms). The two chambers at the top are called atria, and the two chambers at the bottom are called ventricles. Blood flows through the right side of your heart, and then it goes to your lungs and picks up oxygen. Oxygen-rich blood then flows through the left side of your heart. It is pumped out of your heart through an artery (large blood vessel) called the aorta. The aorta carries blood out to other vessels which take it to the rest of your body. Your heart fills up with blood, and then empties blood out with each heartbeat.

Picture of correct blood flow through the heart

Who may need an IABP?

  • Blood vessels that supply blood to your heart muscle may tighten, or get narrow or blocked. When this happens, your heart muscle will have less oxygen-rich blood, causing it to work harder. If your heart muscle does not have enough oxygen for a long period of time, it starts to die. This is called ischemia. You may have ischemia after cardiac arrest (an episode where your heart stops for a time), or if your heartbeat slows down a lot. If you have ischemia, an IABP can help treat it.

  • Caregivers insert an IABP for temporary (short-term) help for people who have heart failure. It may be used to support your heart before you have heart surgery, such as coronary artery bypass graft or angioplasty. If you need surgery, ask your caregiver for more information about the surgery you will be having. The IABP may also be used to keep track of pressure changes inside your aorta before the surgery. The IABP may also be left in for a period of time to help your heart work after you have heart surgery.

How is the IABP inserted?

  • Caregivers will do tests to check the blood flow in your legs. One of your legs will be chosen, and your groin area (the area between your lower abdomen and your thigh) will be cleaned. You will get medicine to decrease or prevent pain. A small incision (cut) will be made through your skin and into the artery beneath the skin. A plastic graft (small tube) will be put into the artery to hold it open. A catheter will be threaded through the artery until it enters the aorta, and is near your heart. When the catheter is in place, the graft will be removed, and the catheter will be left in your aorta.

  • In some cases, the artery in your groin may not be used for IABP insertion. If this happens, a different blood vessel will be used, or the catheter may be put in right through your chest and into your aorta. Fluoroscopy is a special x-ray used during the procedure to watch the catheter as it is inserted, and to check if it is in the correct place. The end of the catheter will be secured to your skin to stop it from coming out.

How does the IABP work?

  • In your aorta, the IABP catheter balloon inflates (fills with air) and deflates (empties the air) at certain times. The balloon inflates when your heart is filling up with blood during a heartbeat. This increases the pressure inside your heart chambers, letting more blood and oxygen go into your heart. The balloon deflates just before your heart pumps blood out during the heartbeat, sending more blood and oxygen out to the rest of your body. This will help blood flow to your heart muscles and decrease the workload of your heart. The balloon fills and empties quickly, keeping pace with your heartbeat. It is timed by monitors inside the balloon, a pacemaker (if you have one), or a speed set by your caregiver. You may need to take blood-thinning or heart medicine when you use an IABP. Ask your caregiver for more information about your medicines.

  • The IABP can help blood flow and send more oxygen to your heart and your body. This may decrease problems such as feeling very tired and having very little energy to do things. It can help your recover faster and better after having heart surgery. Caregivers will watch your condition and tell you when the IABP should be removed. This may be done before you have heart surgery, during surgery, or as you are recovering after surgery.

What are the risks of having an IAPB? If your heart was very damaged before an IAPB is placed, it may not help you as much or as well. Other factors also affect how much or how well the IAPB will help you. If you have diabetes, a blood vessel disease, or if you smoke, you are at a greater risk of having problems with your IABP. These problems include poor or no blood flow to an area of your body, bleeding, infection, blood clots and pain.

When should I call my caregiver? Call your caregiver if:

  • You have shaking chills or a fever.

  • You have burning pain at the place where the catheter was put in.

  • Your bandage becomes soaked with blood.

  • You have questions or concerns about your condition, the IABP, or your medicines.

When should I seek immediate help? Call 911 or get to the nearest emergency room if:

  • The foot or leg on the side of your body where the catheter was put in is cold, pale, has no feeling, or is very painful.

  • The place where your catheter was put in is bleeding, or it has pus or a bad smell coming from it.

  • You have chest pain that spreads to your arms, jaw, or back, or you are sweating more than usual.

  • You have trouble breathing all of a sudden.

  • Your IABP has started to come out, or has fallen all of the way out.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


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