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Augmentation of Coronary Blood Flow With Intra-Aortic Balloon Pump Counter-Pulsation

2000; Lippincott Williams & Wilkins; Volume: 102; Issue: 3 Linguagem: Inglês

10.1161/01.cir.102.3.364

1524-4539

Elizabeth W. Ryan, Elyse Foster,

Cardiac Valve Diseases and Treatments

HomeCirculationVol. 102, No. 3Augmentation of Coronary Blood Flow With Intra-Aortic Balloon Pump Counter-Pulsation Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessOtherPDF/EPUBAugmentation of Coronary Blood Flow With Intra-Aortic Balloon Pump Counter-Pulsation Elizabeth W. Ryan and Elyse Foster Elizabeth W. RyanElizabeth W. Ryan From the University of California San Francisco. and Elyse FosterElyse Foster From the University of California San Francisco. Originally published18 Jul 2000https://doi.org/10.1161/01.CIR.102.3.364Circulation. 2000;102:364–365A78-year-old woman with reduced left ventricular contractile function underwent coronary artery bypass graft surgery (3 saphenous vein grafts and an internal mammary artery graft) and mitral valve repair. Inotropic support and intra-aortic balloon pump (IABP) counterpulsation were required for weaning from cardiopulmonary bypass. The intra-aortic pressure and ECG tracings (Figure 1) on day 2 after surgery are shown. During continuous atrioventricular sequential pacing and 2:1 IABP counterpulsation, enhanced early diastolic aortic pressure (arrows) and reduced aortic end-diastolic pressure during every second cardiac cycle are demonstrated.Figure 2 is a transesophageal echocardiographic image and schematic diagram demonstrating a postoperative pericardial collection and diastolic flow in an epicardial vessel (arrow), representing the saphenous vein graft anastomosed to an obtuse marginal artery. A Doppler signal of this vessel demonstrates increased flow velocity with alternative cardiac cycles (Figure 3). This phenomenon is absent without IABP inflations. Similar Doppler findings of augmented flow velocity with IABP counterpulsation were also noted proximally in the native left anterior descending coronary artery (not shown). The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke's Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.Download figureDownload PowerPoint Figure 1. ECG (top) showing atrioventricular sequential paced rhythm. Aortic pressure trace (bottom) in mm Hg showing augmentation of aortic pressure by an IABP in the descending aorta and synchronized to inflate during alternate cardiac cycles, denoted by arrows.Download figureDownload PowerPoint Figure 2. Transesophageal echocardiographic 2D image with color Doppler and (inset) schematic diagram. Pericardial effusion (PE) surrounds left ventricle (LV). Color Doppler shows epicardial diastolic flow (arrow).Download figureDownload PowerPoint Figure 3. Spectral Doppler recordings of epicardial vessel shown in Figure 2. Augmented diastolic velocity is noted with alternate cardiac cycles (top) during 2:1 IABP counterpulsation. This phenomenon is absent without IABP inflations (bottom).FootnotesCorrespondence to Dr Elyse Foster, Director, Adult Echocardiographic Laboratory, University of California San Francisco, 505 Parnassus Ave, Room M 322, San Francisco, CA 94143-0214. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Taylor A (2018) Left-Ventricular Hemodynamics, Heart Failure, and Shock Textbook of Clinical Hemodynamics, 10.1016/B978-0-323-48042-0.00010-5, (216-248), . 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Gorman J, Gorman R, Milas B and Acker M (2000) Circulatory Management of the Unstable Cardiac Patient, Seminars in Thoracic and Cardiovascular Surgery, 10.1053/stcs.2000.20512, 12:4, (316-325), Online publication date: 1-Oct-2000. July 18, 2000Vol 102, Issue 3 Advertisement Article InformationMetrics Copyright © 2000 by American Heart Associationhttps://doi.org/10.1161/01.CIR.102.3.364 Originally publishedJuly 18, 2000 PDF download Advertisement