Cardiovascular Assist Devices in Cardiogenic Shock

Rolf M. Gunnar, MD; Henry S. Loeb, MD; Sarah A. Johnson, MD; Patrick J. Scanlon, MD
JAMA. 1976;236(14):1619-1621. doi:10.1001/jama.1976.03270150051038.
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AT PRESENT, mechanical circulatory assistance is practical and advantageous for treatment of patients with cardiogenic shock. This technique utilizes a nonocclusive, intraaortic balloon timed to the electrocardiogram (ECG) and monitored by the arterial pulse wave. The balloon inflates just after the aortic valve closes and deflates with the onset of ventricular systole. The inflation forces blood out of the central aorta during cardiac diastole, thereby decreasing central aortic blood volume and increasing pressure. At the onset of systole, balloon deflation decreases aortic pressure so that the left ventricle has less impedance to ejection. The increase in diastolic aortic pressure increases coronary blood flow, while the decreased aortic volume at the onset of systole decreases the work of the left ventricle. The balloon is inserted through the femoral artery and threaded to the descending thoracic aorta just below the origin of the left subclavian artery. Many balloons are designed so that


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