IABP (Intra Aortic Balloon Pump) saved life

2nd August, 2019

inflation and deflation of the intra-aortic balloon

IABP (Intra Aortic Balloon Pump) saved the life of a young man Mr. Azad Khan, 35 years old, resident of Mayang Imphal. Mr. Khan presented to emergency room at 8:30 pm of 1st July, 2019 with acute massive heart attack. By the time he arrived at the hospital he already developed severe heart failure and cardiogenic shock as a complication of the heart attack.

Within minutes of his arrival at SKY, appropriate treatment with loading dose of dual antiplatelets, thrombolytic agent (Tenecteplase) and low molecular weight heparin were started. Simultaneously, multiple intravenous inotropic drugs were initiated to support his severely failing heart. Bipap machine was also put on him to support his breathing difficulty and hypoxia.

On 2nd July, 2019, coronary angiogram performed with a view to coronary stenting showed recanalised Left Anterior Descending Artery. In view of cardiogenic shock on presentation and failure to raise blood pressure with multiple drug supports, IABP was implanted under fluoroscopic screening in the Cath Lab at 11:00 pm of 2nd July, 2019.

IABP works by improving myocardial (heart) oxygen supply and decreasing myocardial oxygen demand, thereby improving the function of failing myocardial cells thereby improving the overall blood pressure and organ perfusion. This mechanism helps supply of blood to vital organs of the body including heart itself and thereby helps save and sustains life of the patient with severe intractable heart failure.

inflation and deflation of the intra-aortic balloon with the pump

The deflated balloon (size 34cc on fully inflated state, Maquet, USA made) was inserted via right femoral artery at groin level and was implanted in the descending thoracic and abdominal aorta (between left subclavian artery above and renal artery below).

It works by inflating the balloon during the diastolic phase of cardiac cycle (when heart is in relaxation) and deflating during the systolic phase of the cardiac cycle when heart contracts to eject more blood to the vital organs of the body.

Immediately after starting the inflation and deflation of the intra-aortic balloon (Fig. 1) with the pump (Fig. 2), the blood pressure (BP) improved from 85/75 mmHg to 112/83 mmHg with augmented BP at 102 mmHg.

Mr. Khan’s left ventricular function (heart function) also started to improve to 55.1% (5/7/19) on the 4th day of starting IABP therapy (normal value of LVEF ranges from 55% to 80%). On 31st July, 2019, on the day of his follow up, Mr. Khan’s LVEF further improved to 62%. Mr. Khan thinks that he was dying on 1st July, 2019. But now he smiles and is like any normal person (seen with a smile with Dr. L. Shyamkishore Singh, Chief Cardiologist & Chairman, SKY Hospital, Imphal West, Fig. 3).

Mr. Azad Khan seen with a smile with Dr. L. Shyamkishore Singh, Chief Cardiologist & Chairman, SKY Hospital

Dr. L Shyamkishore stated that IABP is a life saving machine, if timely used in the hand of experienced cardiologists, saves life. This life saving machine should be made available in any hospital where patients with heart attack and heart failure are treated, where coronary angioplasty or heart surgery is routinely performed to support the heart when heart fails during or immediately in post-operative period.

SKY Hospital has USA made IABP Machine and uses it routinely in the process of saving life of critically ill patients with heart attack/heart failure or during and immediately after complex PCI (Percutaneous Coronary Intervention) & CABG (Coronary Artery Bypass Graft Surgery).

Sd/-
Roni (PRO)
SKY Hospital & Research Centre Pvt. Ltd.