Τίτλος:
Counterpulsation: A concept with a remarkable past, an established
present and a challenging future
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The intra-aortic balloon pump (IABP), which is the main representative
of the counterpulsation technique, has been an invaluable tool in
cardiologists’ and cardiac surgeons’ armamentarium for approximately
half a century. The IABP confers awide variety of vaguely understood
effects on cardiac physiology andmechano-energetics. Although, the
recommendations for its use are multiple, most are not substantially
evidence-based. Indicatively, the results of recently performed
prospective studies have put IABP’s utility in the setting of
post-infarction cardiogenic shock into question. However, the particular
issue remains open to further research. IABP support in high-risk
patients undergoing PCI is associated with favorable long-term clinical
outcome. In cardiac surgery, the use of IABP in cases of peri-operative
low-output syndrome, refractory angina or ischemia-related mechanical
complications is a usual, but poorly justified strategy. Anecdotal cases
of treatment of incessant ventricular arrhythmias, reversal of right
ventricular dysfunction and partial myocardial recovery have also been
reported with its use. Converging data demonstrate the potential of safe
long-term IABP support as a bridge to decision making or a bridge to
transplantation modality in patients with heart failure. The feasibility
of IABP insertion via other than the femoral artery sites enhances this
potential. Despite the fact that several other counterpulsation devices
have been developed and tested overtime none has managed to substitute
the IABP, which continues to be most frequently used mechanical assist
device. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
Συγγραφείς:
Kapelios, Chris J.
Terrovitis, John V.
Siskas, Panagiotis and
Kontogiannis, Christos
Repasos, Evangelos
Nanas, John N.
Περιοδικό:
International Journal of Cardiology
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
Intra-aortic balloon pump; Counterpulsation; Cardiogenic shock
DOI:
10.1016/j.ijcard.2014.01.098
