Intra-Aortic Balloon Pump Malposition Reduces Visceral Artery Perfusion in an Acute Animal Model.

Abstract

Visceral artery perfusion can be potentially affected by intra-aortic balloon pump (IABP) catheters. We utilized an animal model to quantify the acute impact of a low balloon position on mesenteric artery perfusion. In six pigs (78&#x2009;&#xb1;&#x2009;7&#x2009;kg), a 30-cc IABP was placed in the descending aorta in a transfemoral procedure. The celiac artery (CA) and the cranial mesenteric artery (CMA) were surgically dissected. Transit time blood flow was measured for (i) baseline, (ii) 1:1 augmentation with the balloon proximal to the visceral arteries, and (iii) 1:1 augmentation with the balloon covering the visceral arteries. Blood flow in the CMA and CA was reduced by 17 and 24%, respectively, when the balloon compromised visceral arteries compared with a position above the visceral arteries (flow in mL/min: CMA: (i) 1281&#x2009;&#xb1;&#x2009;512, (ii) 1389&#x2009;&#xb1;&#x2009;287, (iii) 1064&#x2009;&#xb1;&#x2009;276, P&#x2009;<&#x2009;0.05 for 3 vs. 1 and 3 vs. 2; CA: (i) 885&#x2009;&#xb1;&#x2009;370, (ii) 819&#x2009;&#xb1;&#x2009;297, (iii) 673&#x2009;&#xb1;&#x2009;315; P&#x2009;<&#x2009;0.05 for 3 vs. 1). The covering of visceral arteries by an IABP balloon causes a significant reduction of visceral artery perfusion; thus, the positioning of this device during implantation is critical for obtaining a satisfactory outcome.