title: Comparing short versus standard-length balloon for intra-aortic counterpulsation: results from a porcine model of myocardial ischaemia-reperfusion.
abstract: OBJECTIVE
  We compare a short and a standard-size balloon with same filling volumes to verify the differences in terms of visceral flow, coronary circulation and haemodynamic performance during aortic counterpulsation in an animal model of myocardial ischaemia-reperfusion injury.
  
  
  METHODS
  Eighteen healthy pigs underwent 120-min ligation of the left anterior descending coronary artery followed by 6 h of reperfusion, and they were randomly assigned to have intra-aortic balloon counterpulsation (IABP) with a 40-ml short-balloon (n = 6) or a 40-ml standard-length balloon (n = 6), or to undergo no IABP implantation (controls, n = 6). Haemodynamics and visceral and coronary flows were measured at baseline (t0), at 2 h of ischaemia (t1) and every hour thereafter until 6 h of reperfusion (from tR1 to tR6), respectively.
  
  
  RESULTS
  Mesenteric flows increased significantly at tR1 only in the short-balloon group (P < 0.001) and it was constantly higher than in the standard-balloon group regardless of mean arterial pressure, systemic vascular resistance and cardiac output (CO; all, P < 0.001). Renal blood flows were significantly increased during IABP treatment with values constantly and significantly higher in short balloons at any following experimental step (all, P < 0.05). IABP improved CO and coronary blood flow, and reduced afterload, myocardial resistances and myocardial oxygen consumption without differences between the short and the standard-length balloon (all, P > 0.05).
  
  
  CONCLUSIONS
  The short balloon prevents visceral ischaemia and, compared with the standard-size balloon, it does not lose IABP beneficial cardiac and coronary-related effects. Further studies are warranted to confirm our findings.
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht - CARIM, Maastricht, Netherlands Careggi University Hospital, Florence, Italy sandro.gelsomino@maastrichtuniversity.nl sandro.gelsomino@libero.it.
authors.forename: Sandro
authors.initials: S
authors.lastname: Gelsomino
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Pieter W J
authors.initials: PW
authors.lastname: Lozekoot
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lorusso
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Monique M J
authors.initials: MM
authors.lastname: de Jong
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Orlando
authors.initials: O
authors.lastname: Parise
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Francesco
authors.initials: F
authors.lastname: Matteucci
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands Careggi University Hospital, Florence, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Lucà
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands Department of Cardiothoracic Surgery, University Hospital, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
authors.affiliation: Careggi University Hospital, Florence, Italy.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.affiliation: Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Jos G
authors.initials: JG
authors.lastname: Maessen
mesh_terms: D000818:Animals; D001011:Aorta / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D004195:Disease Models, Animal; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation* / Q000379:methods*; D008955:Models, Cardiovascular; D017202:Myocardial Ischemia / Q000601:surgery*; D015425:Myocardial Reperfusion / Q000379:methods*; D011897:Random Allocation; D013552:Swine
keywords: Intra-aortic counterpulsation; Ischaemia; Myocardial infarction