Enhanced intra-aortic balloon pump: markedly improved systemic hemodynamics and cardiac function in canines with severe, acute left ventricular failure.

Intra-aortic balloon pumps (IABPs) cannot sustain hemodynamics if the left heart is severely injured. An enhanced IABP was evaluated in 6 anesthetized dogs with acute stenosis of the left anterior descending coronary artery, regional left ventricular (LV) stunning, and global LV dysfunction. An IABP balloon was inserted into the descending aorta and an external chamber containing another IABP balloon was connected to the aorta through a catheter inserted into the left subclavian artery. This emulated the enhanced IABP with a conduit from its external chamber passing axially through an internal IABP balloon. Compared to IABP, enhanced IABP improved hemodynamics and LV function in all conditions. During severe LV dysfunction and circulatory failure, IABP failed to augment diastolic aortic pressure or improve coronary and carotid flows. Enhanced IABP augmented diastolic pressure from 32 +/- 3 mm Hg to 87 +/- 2 mm Hg and increased coronary and carotid flows. Enhanced IABP may be a lifesaving device for patients with severe LV failure.