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The Intra-aortic balloon pump (IABP) is a mechanical device that increases
myocardial oxygen perfusion while at the same time increasing cardiac output.
Increasing cardiac output increases coronary blood flow and therefore myocardial
oxygen delivery. It consists of a cylindrical polyethylene balloon that sits in
the aorta, approximately 2 centimeters (0.79 in) from the left subclavian artery
and counterpulsates. That is, it actively deflates in systole, increasing
forward blood flow by reducing afterload. It actively inflates in diastole,
increasing blood flow to the coronary arteries. These actions combine to
decrease myocardial oxygen demand and increase myocardial oxygen supply.
A computer-controlled mechanism inflates the balloon with helium from a cylinder
during diastole, usually linked to either an electrocardiogram (ECG) or a
pressure transducer at the distal tip of the catheter; some IABPs, such as the
Datascope System 98XT, allow asynchronous counterpulsation at a set rate, though
this setting is rarely used. Helium is used because its low viscosity allows it
to travel quickly through the long connecting tubes, and has a lower risk of
causing an embolism should the balloon rupture.
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