An intra-aortic balloon pump is a device that is placed in the thoracic aorta that increases coronary artery blood flow and reduces the workload on the heart by decreasing the afterload.  It is used on patients with heart failure, acute mitral regurgitation, unstable angina, and patients undergoing PTCA.  

Procedure:

The surgeon will begin by giving the patient heparin to thin the blood and prevent blood clots during the procedure.  After prepping the skin, he will collapse the balloon.  Then, the surgeon will insert a needle into the femoral artery and pass a guidewire through the needle and move it to the thoracic aorta.  Then, a sheath will be passed over the wire to the thoracic aorta.  The balloon is passed through the needle through the sheath into the thoracic aorta and deployed 1cm distal to the left subclavian artery.  This is confirmed either by chest x-ray or fluoroscopy.  Then the wire is removed and the central lumen is hooked to a transducer to monitor the pressure within the aorta.  The balloon pump timing settings are then set.  

Complications (most common):

• Failure to put pump in due to atherosclerotic disease
• Limb ischemia (decreased blood flow through leg)
• Embolization of clots
• Hematoma