Intra-aortic Balloon Counterpulsation Pump

What you should know

• An intra-aortic balloon counterpulsation pump is also called IABP. It is a device used to treat severe (very bad) heart failure and some other heart problems. The pump has a thin flexible and inflatable catheter (tube) with a balloon on its end. It also has a gas container and a device that inflates (fills) and deflates (empties) the balloon. Monitors to see how the heart is working may be connected to the pump. The IABP is used for a short period of time to help your heart work normally. You may need an IABP if you have heart failure, or poor blood flow in your heart. It may also be placed to help your heart work before or after having heart surgery.
  
  
• In your aorta (blood vessel), the IABP catheter balloon inflates (fills with air) and deflates (empties the air) at certain times. The balloon inflates when your heart is filling up with blood during a heartbeat. This increases the pressure inside your heart chambers, letting more blood and oxygen go into your heart. The balloon deflates just before your heart pumps blood out during the heartbeat, sending more blood and oxygen out to the rest of your body. The balloon fills and empties quickly, keeping pace with your heartbeat. The IABP can help blood flow and send more oxygen to your heart and your body. This may decrease problems such as feeling very tired and having very little energy to do things. It can also help your recover faster and better after having heart surgery.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• Risks of having an IABP inserted include bleeding, infection, trouble breathing and blood clots. Blood supply may get blocked, and may lead to death of a body part, such as your leg. If this happens, you may need to have the body part removed. The IABP balloon may burst inside your aorta and the air inside the balloon may leak out. You may have chronic (long-term) pain even with an IABP. The IABP may not help your heart condition. If you do not have the procedure, poor blood flow in your heart, or heart failure may worsen and even lead to death. Call your caregiver if you are worried or have questions about your medicine or care.
  
  

Getting Ready

The week before your procedure:

• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.
  
  
• Tell your caregiver if you know or think that you might be pregnant.
  
  
• Tell your caregiver if you have bleeding problems or are taking medicines such as blood thinners.
  
  
• You may need to have tests done to check your blood vessels such as an angiography or Doppler. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask caregivers about directions for eating and drinking.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be asked to change into a hospital gown and taken on a stretcher to the operating room. The area where the catheter will be inserted will be numbed with medicine to prevent or decrease pain. Your groin area (the area between your lower abdomen and your thigh) will be cleaned. A small incision (cut) will be made through your skin and into the artery beneath the skin. A plastic graft (small tube) will be put into the artery to hold it open. A catheter will be threaded through the artery until it enters the aorta, and is near your heart. Once the catheter is in place, the graft will be removed, and the catheter will be left in.
  
  
• In some cases the artery in your groin cannot be used for IABP insertion. If this happens, a different blood vessel will be used, or the catheter may be put in right through your chest and into your aorta. The end of the catheter will be secured to your skin to stop it from coming out. The area will be covered with bandages.

After your procedure:

You may be moved to a different room after your procedure. You will need to lie flat in bed for a time. If your groin was used to insert the IABP, keep your leg on the same side straight. Do not move your leg, or get out of bed until your caregiver says it is OK. Caregivers will watch you closely for any problems. When caregivers see that you are OK, you may be taken to your hospital room. The bandages used to cover your stitches keep the area clean and dry to help prevent infection. Caregivers will check blood flow to body areas such as your legs often. They may also remove the bandage soon after your procedure to check the IABP insertion area.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the area where the catheter will be put in.

Seek Care Immediately if

• The problems for which you are having the procedure get worse.
  
  

Learn more about Intra-aortic Balloon Counterpulsation Pump (Precare)