Key result
Aortic root balloon pumping boosts coronary flow up to ~100% and reverses cardiogenic shock in dogs.
Why the study?
Aortic root balloon pumping was proposed to treat coronary circulatory failure early in acute myocardial infarction, with limited experimental data on cardiogenic shock.
Does Aortic Root Balloon Pumping improve coronary flow and outcomes in experimental cardiogenic shock compared to standard counterpulsation?
Does Aortic Root Balloon Pumping improve coronary flow and outcomes in experimental cardiogenic shock compared to standard counterpulsation?
Aortic Root Balloon Pumping may be superior to standard counterpulsation for increasing coronary flow and overcoming critical opening pressure in experimental cardiogenic shock.
Answers are grounded in this paper and cite their sources.
May guide mechanical support device development; leaves open translation to human cardiogenic shock.
We propose A.R.B.P. as a means for treatment of acute myocardial infarction, severe angina pectoris and impending myocardial infarction. We have studied the effect of Aortic Root Balloon Pumping on experimental cardiogenic shock. On the basis of these limited study, we believe that aortic root balloon pumping can play the therapeutic role required for the treatment of coronary circulatory failure which develops early in the course of acute myocardial infarction.21)This variation of balloon pumping is superior to counterpulsation and other balloon pumping procedure, when absolute increase in coronary flow is the sole intention.The dramatic effect on experimentally induced cardiogenic shock supports our belief that 1) the A.R.B.P. provides the pressure gradient required to overcome the collaterals critical opening pressure and thus 2) it establishes circulation through these channels to the ischemic area, fast, before irreversible pathological changes occur.A.R.B.P. fills the time lag and in contrast to drug therapy, it resolves the contradictory role which the hemodynamic and the metabolic factors come to play in the course of acute myocardial infarction. This would check the start of the vicious cycle which would otherwise set in.
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Chyong et al. (1971) studied Experimentally induced cardiogenic shock (n=17). Aortic Root Balloon Pumping (A.R.B.P.) vs. No pumping (control group) was evaluated on Hemodynamic recovery and survival. Aortic root balloon pumping increased mean coronary flow by 40-100% and reversed experimentally induced cardiogenic shock in dogs, whereas 5 of 6 unassisted control dogs died within 5 minutes.
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