An IABP is a catheter with a large balloon (40-60 mL) at its tip. It is positioned in the thoracic aorta, via the femoral or axillary artery, distal to the left subclavian artery origin and proximal to the takeoff of the renal vessels. It is timed to inflate during diastole to increase diastolic perfusion pressure to the coronary arteries, great vessels, and major abdominal organs and to deflate just before systole, creating a void in volume within the aorta and thus a low end-diastolic pressure with a resultant decrease in afterload. The decreased afterload increases stroke volume, leading to decreased LVEDP and further increasing coronary perfusion pressure. In summary, an IABP improves coronary perfusion pressures while reducing myocardial oxygen demand.

References

• Baldetti L, Pagnesi M, Gramegna M, et al. Intra-aortic balloon pumping in acute decompensated heart failure with hypoperfusion: from pathophysiology to clinical practice. Circ Heart Fail. 2021;14:e008527.