Intra-Aortic Balloon Pump

An intra-aortic balloon pump (IABP) is a widely used device that helps the heart pump more blood. It does this by making it easier for the cardiac muscles to open the aortic valve and eject blood. It’s used in people with cardiac-related shock or severe coronary artery disease. Healthcare providers commonly place this device only in the intensive care unit.

An IABP has a tube (catheter) with a balloon at one end that goes inside your body. At the other end, outside your body, the catheter connects to a console with a gas line for helium. The console tells the pump when to deflate and inflate.

Typically, when your heart contracts, it sends blood out to the rest of your body. When your heart relaxes, it fills with blood. An intra-aortic balloon pump deflates when your heart pumps blood out, and then inflates with helium when your heart relaxes.

An IABP stays in place for only a few days. Healthcare providers typically use the device when you’re in the hospital after surgery or a cardiac event. Some people may need an IABP before or after cardiac procedures like angioplasty or bypass surgery for a blocked artery. You may also have one while you wait for a long-term device.

Why might I need intra-aortic balloon pump therapy?

You may need an IABP to treat cardiogenic shock. This means your heart isn’t pumping enough blood to meet your body’s demand for it. This type of shock may develop because of:

• Acute heart failure with low blood pressure
• Abnormal heart rhythms
• Heart muscle inflammation (myocarditis)
• Narrow or blocked coronary arteries, which can cause a heart attack

What are the reasons people don’t get an intra-aortic balloon pump?

It’s unsafe to get an IABP if you have:

• A weak, bulging aortic wall (aortic aneurysm)
• Aortic dissection
• A leaky aortic valve (aortic regurgitation)
• Severe peripheral artery disease
• Uncontrolled sepsis
• A risk of uncontrolled bleeding

What are the potential risks of IABP therapy?

Your risks depend on multiple factors, including your age and overall health. In general, the risks of an intra-aortic balloon pump may include:

• Balloon rupture, which could lead to blood clots
• Excessive bleeding
• Incorrect balloon positioning
• Infection
• Injury to an artery
• Decrease in blood flow to your limbs
• Tear in your aorta (dissection or rupture)

What happens during this procedure?

If you’re already in cardiac surgery when your healthcare provider places the IABP, you’ll be asleep for the procedure. Otherwise, your provider may give you numbing medicine (local anesthesia) to reduce the chance of pain during the procedure.

During an intra-aortic balloon pump placement, your healthcare provider:

1. Inserts a hollow tube called a catheter into the femoral artery in your groin.
2. Threads the balloon through the catheter.
3. Uses X-ray or ultrasound imaging to guide the balloon and catheter up to your chest and into your aorta (the largest artery in your body).
4. Uses stitches to secure the device at both ends and keep it in place.
5. Attaches the IABP to a machine that tells the balloon when to inflate and deflate.
6. Checks balloon placement with a chest X-ray.

What happens after receiving an IABP?

You may feel some chest pain during IABP placement. This pain should go away within a few minutes. More commonly, the device will help improve chest pain if you receive the IABP for severe coronary artery disease that doesn’t respond to medical management.

You’ll stay in bed with your head slightly elevated while the IABP is in place. The catheter will stay in your leg. You’ll need to keep your leg straight to prevent the balloon from moving out of position.

Usually, providers will give you a blood thinner called heparin after placing an intra-aortic balloon pump. Heparin helps prevent blood clots from forming.

You’ll likely have a chest X-ray each day to make sure the IABP is still in the correct place.

What is the recovery time?

Most people stay on an IABP for a few days, or until they have a procedure in the cath lab or a surgery. It depends on why you received the device. Your healthcare provider may temporarily stop the balloon pump after a few days to see how you respond. If your heart pumps well on its own, your provider may remove the balloon pump. You’ll need at least two hours of bed rest after the IABP is out.

In severe cases, you may need to keep using the IABP until another option is available, like a left ventricular assist device or a donor heart for a transplant.

When should I call my healthcare provider?

If you’re in the hospital, your care team will be watching for any problems that develop.

Let your team know if you have any signs of infection or complications after a cardiac procedure, including:

• Excessive swelling or redness around the incision site
• Fever
• Heart palpitations
• Increased shortness of breath
• Swelling in your ankles or hands
• Weight gain of more than five pounds in one week

How long can an intra-aortic balloon pump stay in?

An IABP usually only stays in place for a few days. But your healthcare provider may keep it in place for up to 30 days, or sometimes longer.