THE EFFICACY OF CONCOMITANT USE OF LHB AND IABP FOR ISCHEMIC CARDIOGENIC SHOCK

THE EFFECT OF CARDIAC FUNCTION AND CORONARY CIRCULATION

Abstract

In order to evaluate the efficacy of concomitant use of left heart bypass (LHB) and intra-aortic balloon pumping (IABP) for the cardiac function and coronary circulation in post ischemic cardiogenic shock, we made comparison studies in swain. Cardiogenic shock due to acute myocardial infarction was made experimentally by LAD ligation. LHB was performed by centrifugal pump (Bio Medicus BP-80), supporting flows of half cardiac output. IABP balloon catheter (20cc) was inserted to aorta through the femoral artery and pumped. These models were supported by IABP, LHB, and IABP+LHB, comparing each cardiac performance. Myocardial infarcted area was evaluated by epicardial mapping ECG. Coronary blood flow and velocity were analyzed by electrical flow meter and ultrasonic pulsed dopplar velocimeter respectively. In the IABP+LHB group, coronary blood flow were increased remarkably and ishemic areas were significantly reduced and their hearts recovered from cardiogenic shock, demonstrating a good supply and demand balance of myocardial oxygen. The systolic reverse wave of the LAD flow and velocity which was increased due to cardiogenic shock, was reduced remarkably in the IABP+LHB group. These results suggested this concomitant method was suitable assist for coronary circulation because of diastolic augmentation by IABP and cardiac unloading by LHB.