Reduction of myocardial necrosis by positioning the intra-aortic balloon pump in the ascending aorta.
The presence of severe peripheral vascular disease may necessitate inserting an intra-aortic balloon pump (IABP) directly into the ascending aorta. As positioning an IABP into the descending aorta may be hazardous and difficult through the ascending aorta, this experimental study sought to determine the effects of positioning an IABP in the ascending aorta on myocardial recovery during urgent surgical revascularization. The second and third diagonal coronary arteries in 30 pigs were occluded with snares for 90 min followed by 30 min of cardioplegic arrest and 180 min of reperfusion with the snares released. During the period of coronary occlusion, ten pigs received an IABP in the descending aorta, ten had an ascending aorta IABP and ten received no IABP support. The best recovery of wall motion, least tissue acidosis and lowest area of necrosis occurred when an IABP was positioned in the ascending aorta. It is concluded that myocardial recovery is enhanced when an IABP is positioned in the ascending aorta during urgent surgical revascularization.
Lazar
H L
HL
Department of Cardiothoracic Surgery, Boston University Medical Center, Massachusetts.
Matsuura
H
H
Rivers
S
S
Shemin
R J
RJ
D000138:Acidosis / Q000503:physiopathology / Q000517:prevention & control; D000818:Animals; D001011:Aorta / Q000473:pathology*; D001013:Aorta, Thoracic / Q000473:pathology; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery; D006321:Heart / Q000503:physiopathology; D006324:Heart Arrest, Induced; D006863:Hydrogen-Ion Concentration; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation* / Q000379:methods; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D009204:Myocardial Revascularization; D009206:Myocardium / Q000473:pathology; D013552:Swine