Document Detail


An experimental study of intra aortic balloon pumping within the intact human aorta.
MedLine Citation:
PMID:  9332931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intra-aortic balloon pumping is a therapeutic technique which carries a significant morbidity related to the interaction between the balloon catheter and the aorta. The aim of this study was to visualise directly the dynamic action of the balloon catheter within the cadaveric human aorta in an artificial circulation. METHODS: An artificial circulation was constructed using of PVC tubing, a filter and a roller pump. A series of five intact cadaveric human aortas were then individually studied by placing each in series within the circuit. A balloon catheter was advanced via the left common iliac artery into the descending aorta under direct angioscopic vision. Balloon pumping was then commenced. The circuit was perfused with normal saline at a flow rate of 3 l/min. Pump actions of 1:1 and 1:2 were simulated. Each aorta at the end of the experiment was subjected to histological examination. RESULTS: The balloon only appeared to make direct contact with the wall of the aorta during deflation when it was swept to one side by the circulating fluid. During maximal inflation the only points of contact were the tip of the catheter and the entry site. Side branches of the aorta were not occluded by the balloon. There was considerable atheromatous debris visualised within the lumen of the aorta. Atheromatous plaques were seen to fissure and disrupt by a pressure wave action and not by direct contact with the balloon. CONCLUSION: The balloon catheter moves relative to the wall of the aorta during inflation and deflation. Contact between the balloon and the aorta only occurs during deflation. Side branches of the aorta are not occluded by the catheter. Plaque disruption and embolus formation appear to result from pressure wave action rather than direct contact with the balloon. This may have implications for future balloon design. Further investigation of this poorly understood interaction between the balloon and the aortic wall is required.
Authors:
G Tierney; H Parissis; M Baker; D Austin; C Clelland; D Richens
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  12     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-11-06     Completed Date:  1997-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  486-93     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Nottingham City Hospital, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioscopy
Aorta / injuries*,  pathology*
Blood Pressure
Cadaver
Embolism, Cholesterol / etiology*,  pathology
Equipment Design
Female
Hemorheology
Humans
Intra-Aortic Balloon Pumping / adverse effects*
Male
Middle Aged
Models, Cardiovascular*
Pulsatile Flow

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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