Intra-aortic balloon pump

The intra-aortic balloon pump is a temporary cardiac support device. It consists of a long balloon placed in the descending thoracic aorta and connected to a console at the bedside. Synchronised with the electrocardiogram, it inflates when the heart relaxes, which improves blood supply to the coronary arteries, then deflates just before the heart contracts, which reduces the effort the heart must make to pump blood out. The balloon is inserted through the femoral artery at the groin, under local anaesthesia, and positioned under X-ray guidance, most often in the catheterisation laboratory. It stays in place for a few hours to a few days, while the heart recovers or a definitive treatment is carried out. The patient is continuously monitored in an intensive care unit, with anticoagulant treatment and the need to keep the affected leg straight. It is used in severe, selected situations: certain mechanical complications of a heart attack (rupture of the septum or acute mitral leak) while awaiting surgery, certain types of cardiogenic shock, very high-risk angioplasty, or severe heart failure awaiting another treatment. Its use is not routine and is decided case by case by the cardiology and intensive care team. At Clinique Pasteur Tunis, insertion takes place in the catheterisation laboratory and monitoring is provided in the cardiac intensive care unit or the cardiac surgical intensive care unit.