PURPOSE OF REVIEW: The intra-aortic balloon pump (IABP) has been used as a cardiac assist device in various clinical situations since 1968 on the basis of the physiological principles and observational data, with little randomized data until recently. RECENT FINDINGS: Recently published randomized controlled trials (RCTs) and meta-analyses have demonstrated acceptable safety for IABP but have raised doubt over efficacy in acute myocardial infarction (MI) both with and without cardiogenic shock. RCTs and meta-analyses have provided limited and qualified support for the efficacy of IABP in high-risk percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). There remains only observational data to support the efficacy of IABP in other niche indications, including mechanical complications of MI (acute severe mitral regurgitation and ventricular septal rupture) and refractory ventricular arrhythmia. SUMMARY: Current randomized trial data and meta-analyses support the safety of IABP, but provide limited or no support for its efficacy in the treatment of high-risk MI, MI complicated by cardiogenic shock or the use of prophylactic IABP in high-risk PCI and CABG. Further studies to inform optimal patient selection, timing and use of associated therapies are required to characterize the role of IABP in contemporary practice and optimize outcome in high-risk patient subsets.
PURPOSE OF REVIEW: The intra-aortic balloon pump (IABP) has been used as a cardiac assist device in various clinical situations since 1968 on the basis of the physiological principles and observational data, with little randomized data until recently. RECENT FINDINGS: Recently published randomized controlled trials (RCTs) and meta-analyses have demonstrated acceptable safety for IABP but have raised doubt over efficacy in acute myocardial infarction (MI) both with and without cardiogenic shock. RCTs and meta-analyses have provided limited and qualified support for the efficacy of IABP in high-risk percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). There remains only observational data to support the efficacy of IABP in other niche indications, including mechanical complications of MI (acute severe mitral regurgitation and ventricular septal rupture) and refractory ventricular arrhythmia. SUMMARY: Current randomized trial data and meta-analyses support the safety of IABP, but provide limited or no support for its efficacy in the treatment of high-risk MI, MI complicated by cardiogenic shock or the use of prophylactic IABP in high-risk PCI and CABG. Further studies to inform optimal patient selection, timing and use of associated therapies are required to characterize the role of IABP in contemporary practice and optimize outcome in high-risk patient subsets.
Authors: Ju Hee Lee; Min Seok Kim; Byung Su Yoo; Sung Ji Park; Jin Joo Park; Mi Seung Shin; Jong Chan Youn; Sang Eun Lee; Se Yong Jang; Seonghoon Choi; Hyun Jai Cho; Seok Min Kang; Dong Ju Choi Journal: Korean Circ J Date: 2019-01 Impact factor: 3.243
Authors: Juan Diego Sánchez Vega; Gonzalo Luis Alonso Salinas; José María Viéitez Florez; Albert Ariza Solé; Esteban López de Sá; Ricardo Sanz-Ruiz; Virginia Burgos Palacios; Sergio Raposeiras Roubin; Susana Gómez Varela; Juan Sanchís Forés; Lorenzo Silva Melchor; Xurxo Martínez-Seara; Lorena Malagón López; Ana Viana Tejedor; Miguel Corbí Pascual; José Luis Zamorano Gómez; Marcelo Sanmartín-Fernández Journal: Cardiol J Date: 2022-05-17 Impact factor: 3.487