Introduction
An intra-aortic balloon pump (IABP) is a temporary support device for a heart that is not pumping well. A long, thin tube with a balloon at the tip is placed in the aorta, usually through an artery in the groin.
The balloon inflates and deflates in time with each heartbeat, driven by a machine at the bedside. This helps the heart pump more easily and improves blood flow to the heart muscle.
Why the procedure is needed
A balloon pump may be used when the heart is very weak or short of blood supply, for example:
- After a large heart attack, when the heart pumps poorly (cardiogenic shock)
- Before, during or after heart surgery, when the heart needs temporary support
- During high-risk angioplasty in a patient with a weak heart
- In severe angina or rhythm problems that do not settle with medicines, while awaiting definitive treatment
- As a bridge while the heart recovers or until another treatment can be given
Who may benefit
- Patients in intensive care or the cath lab whose heart needs short-term mechanical support
- Patients with heart failure or low blood pressure after a heart attack or heart surgery
- Patients awaiting bypass surgery, angioplasty or other treatment who need stabilising
- It may not be suitable for patients with significant aortic valve leakage, severe aortic disease or severe disease in the leg arteries
- Other support devices may be considered when more help is needed
How the balloon helps
- Inflation while the heart relaxes
- The balloon inflates when the heart is resting between beats, pushing blood on to the heart muscle and the body.
- Deflation before the heartbeat
- It deflates just before the heart contracts, making it easier for the heart to push blood out.
- Temporary support
- It is a short-term measure, usually for days, to support the heart until it recovers or until definitive treatment.
- Anticoagulation and monitoring
- Blood-thinning medicine and close monitoring of circulation in the leg are needed.
- Weaning
- As the heart improves, the support is reduced gradually and then the balloon is removed.
Procedure overview
Step 1: Decision
The cardiology or surgical team decides that the heart needs temporary support and explains the reason to the family.
Step 2: Insertion
After numbing the skin, the catheter with the balloon is placed through an artery in the groin and advanced into the aorta, guided by imaging.
Step 3: Connection
The catheter is connected to a console that inflates and deflates the balloon in time with the heartbeat.
Step 4: Intensive-care monitoring
Heart rhythm, blood pressure, urine output, leg circulation and bleeding are watched closely, and blood thinners are given as directed.
Step 5: Weaning
When the heart is stronger, the support is reduced step by step.
Step 6: Removal
The balloon is removed, and pressure is applied to the artery site to stop bleeding. The leg is checked afterwards.
Clinical advantages
- Helps a weak heart pump and may improve blood flow to the heart muscle
- Can stabilise a patient in the critical period after a heart attack or heart surgery
- Less invasive than some other support devices
- Can be put in quickly, including at the bedside
Risks and considerations
Every operation carries risk. The points below are general; your own risk depends on your health and on the operation you need.
- Bleeding or bruising at the insertion site, or from blood thinners
- Poor blood flow to the leg, which is checked regularly and may need the balloon to be removed
- Infection, balloon displacement or a tear in the artery (uncommon)
- Low platelet counts or clot formation
- It supports the heart but does not treat the cause, so other treatment is still needed
Frequently asked questions
Does the balloon pump cure the heart problem?
No. It supports the heart for a short time while the heart recovers or while other treatment is arranged.
Will I be awake?
Often patients are awake or lightly sedated. You will need to keep the leg straight and lie in bed while it is in place.
How long does it stay in?
Usually from several hours to a few days, depending on how the heart responds.
Is it painful to remove?
Removal is generally brief. Pressure is applied to the groin afterwards, and you will need to lie flat for a while.
What if the heart is still weak?
Your team may consider other treatments or other support devices. They will explain the options.
Patient-friendly summary
An intra-aortic balloon pump is a temporary device that helps a weak heart pump by inflating and deflating a balloon in the aorta in time with the heartbeat. It is used in intensive care and in the cath lab for a short period, while the heart recovers or the main treatment is carried out. It carries risks, and the decision to use it is made by your cardiology team.