This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fuchs, R. M. Articles by Yin, F. C. Search for Related Content PubMed PubMed Citation Articles by Fuchs, R. M. Articles by Yin, F. C.

Circulation, Vol 68, 117-123, Copyright © 1983 by American Heart Association

ARTICLES

Augmentation of regional coronary blood flow by intra-aortic balloon counterpulsation in patients with unstable angina

RM Fuchs, KP Brin, JA Brinker, PA Guzman, RR Heuser and FC Yin

Intra-aortic balloon counterpulsation is capable of reducing afterload in patients with unstable angina. Whether it is also capable of augmenting coronary blood flow to poststenotic myocardium is controversial. We studied seven patients receiving maximal drug therapy and requiring balloon pumping for unstable angina as balloon volume and assist ratio were altered. All patients had greater than 90% stenosis of the proximal left anterior descending coronary artery. With maximal augmentation (40 cc balloon volume, 1:1 assist ratio) great cardiac vein flow, representing the efflux from the left anterior descending coronary artery bed, rose from a baseline of 52 +/- 20 to 67 +/- 25 ml/min (mean +/- SD, p = .004) and mean aortic diastolic pressure increased from 77 +/- 13 to 99 +/- 33 mm Hg (p = .004). Increased great cardiac vein flow correlated with increased mean aortic diastolic pressure across changes in balloon volumes (off, 20 cc, 30 cc, and 40 cc) and changes in assist ratio (off, 1:4, 1:2, and 1:1) (p = .02). However, the intermediate balloon volumes produced great cardiac vein flows at an intermediate level between full assist and no assist (p less than .05), whereas the intermediate assist ratios did not augment flow. Thus balloon pumping increased flow to a bed fed by collateral vessels or critical stenoses; this increased flow correlated with increased aortic diastolic pressure, indicating probable loss of autoregulatory ability.

This article has been cited by other articles:

				E. C. McGee Jr., P. M. McCarthy, and N. Moazami Temporary Mechanical Circulatory Support Card. Surg. Adult, January 1, 2008; 3(2008): 507 - 534. [Full Text]

				N. Moazami and P. M. McCarthy Temporary Circulatory Support Card. Surg. Adult, January 1, 2003; 2(2003): 495 - 520. [Full Text]

				H. Jeanmart, L. P. Perrault, N. Desjardins, O. Chavanon, M. Carrier, and J. D. Fonger Arterial balloon catheter: a new atraumatic device for dilating arterial grafts Ann. Thorac. Surg., September 1, 2001; 72(3): 810 - 815. [Abstract] [Full Text] [PDF]

				G. Bolotin, T. Wolf, R. Shachner, F. H. van der Veen, R. Shofti, R. Lorusso, J. J. Shreuder, and G. Uretzky Hemodynamic evaluation of descending aortomyoplasty versus intra-aortic balloon pump performed in normal animals: an acute study Eur. J. Cardiothorac. Surg., February 1, 2001; 19(2): 174 - 178. [Abstract] [Full Text] [PDF]

				G. Bolotin, T. Wolf, F. H. van der Veen, R. Shofti, R. Loruso, J. J. Shreuder, and G. Uretzky Acute descending aortomyoplasty induces coronary blood flow augmentation Ann. Thorac. Surg., November 1, 1999; 68(5): 1668 - 1675. [Abstract] [Full Text] [PDF]

				J Galea, J Armstrong, S.E Francis, G Cooper, D.C Crossman, and C.M Holt Alterations in c-fos expression, cell proliferation and apoptosis in pressure distended human saphenous vein Cardiovasc Res, November 1, 1999; 44(2): 436 - 448. [Abstract] [Full Text] [PDF]

				J. D. Crouch, D. P. O’Hair, J. P. Keuler, T. P. Barragry, P. H. Werner, and L. H. Kleinman Open versus endoscopic saphenous vein harvesting: wound complications and vein quality Ann. Thorac. Surg., October 1, 1999; 68(4): 1513 - 1516. [Abstract] [Full Text] [PDF]

				J. C. Cardone, P. D. Yoon, D. R. Trumble, and J. A. Magovern Regional Effects of Aortomyoplasty in Acute Ischemia Ann. Thorac. Surg., January 1, 1996; 61(1): 426 - 429. [Abstract] [Full Text]