Prolonged circulatory support with the intra-aortic balloon pump after myocardial infarction.

Circulation was supported by intra-aortic balloon counterpulsation for 30 and 38 days respectively in two patients with cardiogenic shock after acute myocardial infarction. One was flown 1400 km to Cape Town for heart transplantation but died after being weaned from the pump while awaiting a suitable donor. The other underwent successful surgical closure of a ruptured ventricular septum on the 30th day, allowing time for the edges of the ventricular septal defect to fibrose. Neither significant damage to circulating blood elements nor infection occurred, confirming the feasibility of prolonged circulatory support.