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Results for “Intra-Aortic Balloon Pumping”

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At least 19 recordsLinked to original sources
PubMed1979

[The efficacy of the intra-aortic balloon pump for patients with heart failure complicating acute myocardial infarction (author's transl)].

Assisted circulation was carried out with the help of an intra-aortic balloon pump in 22 patients with acute transmural myocardial infarction and heart failure (despite medication). Two patients died in hospital. The combination of the balloon pump and nitrates proved to be particularly effective. The follow-up examination of the survivors showed a distinct pulmonary arterial pressure during ergometry. All of the examined patients revealed extensive akinetic and diskinetic areas, significant stenosis being detectable either in the proximal area of the Ramus descendens anterior or in two or three blood vessels.

Adult↗
PubMed1979

[Role of intra-aortic balloon pumping in coronary surgery for stenosis of the left common coronary trunk].

Surgical treatment for stenosis of the left main coronary artery is associated with a high risk related to particular vulnerability to acute myocardial ischaemia during the period of induction of anaesthesia. Eight cases of stenosis of the left main coronary artery undergoing surgery with preoperative insertion of an intra-aortic counter-pressure balloon are reported here. The results - eight successes - as opposed to four failures seen prior to the use of this technique and in similar cases, leads the authors to suggest stenoses of the left main coronary artery as a further criterion indicating the need for routine preoperative intra-aortic counter-pressure

Aged↗
PubMed1978

[Treatment of early post-infarction ventricular aneurysms by assisted circulation and surgery].

Ventricular aneurysm formation in the 3 months following transmural myocardial infarction is rare but may cause serious complications. Cardiac failure and/or ventricular arrhythmias resistant to medical treatment are indications for ventricular resection. The operative mortality is high in this group of patients. 8 patients with ventricular aneurysms of average volume (124 +/- 117 ml/m2) and very impaired left ventricular function (EF : 21 +/- 10%, akinesia : 53 +/- 10%) were operated on with two early deaths and one death in the 7th post operative month. The long term clinical result was satisfactory in the surviving patients, and confirmed by haemodynamic investigation in two of them. The benefical effects of intra-aortic balloon pumping, used preoperatively in all patients, and associated myocardial revascularisation procedures performed in some of them are discussed.

Aged↗
PubMed1979

[Measures to reduce infarct size (author's transl)].

Reduction of infarct size is a concept limited in clinical practice by the long period elapsing before hospital admission. Most patients are admitted only after the critical period of 6 to 8 hours following infarction when it might be possible to save the ischaemic, but not yet necrotic myocardium. Nevertheless, patients with altered haemodynamics and, therefore, a disturbed myocardial balance between oxygen requirement and oxygen supply may benefit from optimum management of the haemodynamic situation. This is achieved primarily by manipulation of preload and afterload and by enhancement of the collateral circulation to the ischaemic myocardium. However, the effects of cardiac surgery are limited by the negative sequelae of late reperfusion 6 hours after coronary ligation. Intra-aortic balloon pumping can be used only in large cardiosurgical centres because most of the so-treated patients remain pump dependent. The described measures have improved the hospitalisation period in patients with acute myocardial infarction, but the further prognosis is dictated by the nature and extent of underlying coronary heart disease.

Animals↗
PubMed1979

Variant angina. Clinical spectrum and results of medical and surgical therapy.

Fifty-four patients with variant angina are described. They are divided into patients without hemodynamically (less than 50%) important coronary artery lesions (Group 1), patients with intermediate (greater than or equal to 50% and less than 90%) fixed obstruction (Group 2A), and patients with high grade (greater than or equal to 90%) fixed obstruction (Group 2B). Inferior ischemia occurred significantly more often in Group 1 (90% versus 33%. p less than 0.001), and exertional angina was more frequent in Group 2 (70% versus 36%, p less than 0.05). Maximum medical therapy with propranolol and nitrates failed to control angina in 55% of Group 1, 69% of Group 2A, and 63% of Group 2B. Twelve patients underwent intra-aortic balloon pumping (IABP), and in 10 there was complete control of variant angina. A total of 35 Group I patients underwent coronary artery bypass grafting (CABG), with a 2.9% mortality rate in patients without preoperative cardiogenic shock. Of these patients, 55% in Group 2A and 73% in Group 2B experienced marked improvement in their angina status. Therefore, we currently recommend bypass grafting for medically intractable variant angina in those patients with severely stenotic, fixed atherosclerotic lesions.

Angina Pectoris↗
PubMed1978

Pre-infarction angina secondary to calcific aortic stenosis with Bernheim's effect.

Pre-infarction angina, in the absence of coronary artery disease, was found in a 62 year-old man with severe calcific aortic stenosis. After application of intraaortic balloon pump counter-pulsation, the condition was stabilized, and coronary arteriograms were safely carried out. Interestingly, an elevated right atrial and right ventricular end-diastolic pressure with an associated Bernheim's effect was demonstrated by cardiac catheterization. The hemodynamics of the right heart returned to normal after surgical correction of the aortic stenosis. The clinical indications for intra-aortic balloon pump counterpulsation in this setting are discussed.

Angina Pectoris↗
PubMed1979

The effects of intraaortic balloon counterpulsation on myocardial infarct size.

The left anterior descending coronary artery was ligated in 6 baboons. Subsequently, 3 animals were supported with long-term (24-hour) intraaortic balloon pumping (IABP), and 3 were on coronary occlusion alone. Animals were studied hemodynamically and with unipolar electrocardiographic mapping acutely and then were studied after a week and killed. A histological measurement of infarct size was made. The use of IABP had no influence on the area of ischemia determined by unipolar mapping or on infarct size measured quantitatively at a week. Similarly, there were no acute hemodynamic differences between the two groups. The only significant difference noted was a reduction in systolic pressure in IABP animals during balloon pumping and a significantly higher left ventricular systolic pressure a week following infarction in animals treated with IABP. The data indicate no significant effect of IABP on altering infarct size in animals with acute coronary ligation in the absence of cardiogenic shock.

Animals↗
PubMed1979

Medically refractory unstable angina pectoris. II. Hemodynamic and angiographic effects of intraaortic balloon counterpulsation.

Of 60 patients receiving intraaortic balloon counterpulsation for angina refractory to maximal medical therapy, a subgroup of 10 patients underwent left ventricular angiography both with and without counterpulsation. Severe stenosis of the left anterior descending coronary artery was present in all 10 patients. Counterpulsation resulted in a significant decrease in systolic and end-diastolic left ventricular pressures and no increase in cardiac index. Left ventricular diastolic and systolic volume, ejection fraction and regional contraction patterns, often abnormal, were unchanged. However, mean normalized systolic ejection rate was improved by the addition of counterpulsation. It is concluded that intraaortic balloon counterpulsation has relatively little effect on the left ventricular volume of patients with medically refractory angina pectoris. The symptomatic improvement that takes place seems to occur mainly through the effect of counterpulsation on preload and afterload.

Administration, Oral↗
PubMed1978

Total support of the circulation of a patient with post-cardiotomy stone-heart syndrome by a partial artificial heart (ALVAD) for 5 days followed by heart and kidney transplantation.

A patient with acute bacterial endocarditis in whom ischaemic contracture of the left ventricle (stone-heart syndrome) developed during aortic and mitral valve replacement had an emergency implantation of an intracorporeal partial artificial heart (an abdominal left-ventricular assist device of ALVAD). This device functioned as a total artificial heart for nearly 6 days, while a donor heart for transplantation was sought. The ALVAD was then removed, and the patient received allografts of a heart and a kidney. The transplanted heart functioned well, but the patient died 15 days later from gram-negative sepsis. There was no evidence of cardiac or renal allograft rejection.

Acute Disease↗
PubMed1979

[Aortocoronary bypass for the threatened spread of acute myocardial infarction].

21 patients with unstable angina in the acute myocardial infarction period were treated by early surgery, on average on the 3th day after infarction. Resistance to medical therapy given in the coronary care unit, associating modern pharmacological agents and circulatory assistance, on the one hand, and the presence of lesions on the coronary arteries accessible to surgery on the other, were the surgical indications. The absence of operative mortality and of electrical changes after operation seem to be related to the many advances made in the various stages of the medico-surgical management. These results suggest that revascularisation surgery with an acceptable risk may be proposed to patients with unstable angina after a recent myocardial infarction.

Acute Disease↗