title: [Endothelial lesions caused by intra-aortic counterpulsation balloons].
abstract: Intra-aortic balloon pump (IABP) is the most frequently used mechanical circulatory support. Repeated trauma on the aortic wall has been reported as a cause of balloon perforation by endothelial denudation of atheromatous plaque. This study analyses the effect of IABP on the endothelium of the calf aorta. In 12 calves (mean weight: 72 +/- 6 kg) an IABP was inserted by femoral route and left during 6 hours on internal mode with a frequency of 80 cycles/min. The animals were sacrificed after the procedure (n = 4), at postoperative day (POD) 7 (n = 4), and at POD 14 (n = 4). In the aorta facing the balloon, nine transmural samples were taken proximally (n = 3), at mid height (n = 3) and distally (n = 3), for histological analysis of the percentage of aortic surface covered with endothelium. The percentage of aortic surface covered with endothelium at POD 0, 7 and 14 was proximally: 72.5 +/- 27.5%, 83.7 +/- 16.9% and 93.3 +/- 8.9% respectively; at mid-height: 50.8 +/- 30.7%, 65 +/- 25% and 95 +/- 5%; and distally: 31.4 +/- 20.1%, 48.3 +/- 34.4% and 85 +/- 10%. A large portion of the aortic endothelium is abraded after 6 hours of IAB pumping. This effect is more important at the distal level of the aorta. After two weeks, most of the endothelium has regenerated.
authors.affiliation: Service de Chirurgie Cardio-vasculaire, CHUV (Centre Hospitalier Universitaire Vaudois), Lausanne. Xavier.Mueller@chuv.hospvd.ch
authors.forename: X M
authors.initials: XM
authors.lastname: Mueller
authors.forename: H
authors.initials: H
authors.lastname: Tevaearai
authors.forename: B
authors.initials: B
authors.lastname: Marty
authors.forename: P
authors.initials: P
authors.lastname: Tozzi
authors.forename: M
authors.initials: M
authors.lastname: Augstburger
authors.forename: C Y
authors.initials: CY
authors.lastname: Genton
authors.forename: L K
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D000818:Animals; D001012:Aorta, Abdominal / Q000293:injuries* / Q000473:pathology; D002417:Cattle; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000293:injuries* / Q000473:pathology; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*