Ascending versus descending aortic balloon

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Presentation transcript:

Ascending versus descending aortic balloon Bart P Meyns, MD, PhD, Yousuke Nishimura, MD, PhD, Ramadan Jashari, MD, Rozalia Racz, MD, PhD, Veerle H Leunens, Willem J Flameng, MD, PhD The Annals of Thoracic Surgery Volume 70, Issue 4, Pages 1264-1269 (October 2000) DOI: 10.1016/S0003-4975(00)01703-3

Fig 1 The ascending aortic balloon pump (ICS-Supracor). Its oval-shaped balloon has a volume of 45 cc and is designed to occlude the ascending aorta distally to maximize aortic root pressure. The Annals of Thoracic Surgery 2000 70, 1264-1269DOI: (10.1016/S0003-4975(00)01703-3)

Fig 2 Experimental protocol. Two periods of coronary stenosis are applied (each 10 minutes). The balloon pump support (ICS or IABP) is applied during the last 5 minutes. Colored microspheres (MS) are injected at baseline, during the first ischemia, during the first balloon pump support, during the second ischemia, and during the second balloon pump support. The type of balloon pump used (IABP or ICS) alternated between experiments. The Annals of Thoracic Surgery 2000 70, 1264-1269DOI: (10.1016/S0003-4975(00)01703-3)

Fig 3 Chart recording of the left ventricular pressure (LVP), aortic root pressure (ABP), and coronary flow (CF) during ICS counterpulsation and in control situation. The first five heartbeats were assisted with the ICS, the following were not. The increase in aortic blood pressure during diastole has an immediate effect on coronary flow (arrows). The Annals of Thoracic Surgery 2000 70, 1264-1269DOI: (10.1016/S0003-4975(00)01703-3)

Fig 4 Subepicardial (white bars) and subendocardial (black bars) myocardial blood flow at baseline, during ischemia, IABP support, and ICS support. (A) Mean myocardial blood flow in all regions. (B) Myocardial blood flow in the ischemic regions (supplied by the stenosed vessel: lateral wall). (C) Myocardial blood flow in the nonischemic regions. ∗A significant difference as compared with the flow during unsupported ischemia. †A significant difference between ICS and IABP values. The Annals of Thoracic Surgery 2000 70, 1264-1269DOI: (10.1016/S0003-4975(00)01703-3)