Key result
Subclavian IABP successfully bridges refractory cardiogenic shock to heart transplantation over ~290 days.
Why the study?
The intra-aortic balloon pump is widely used as temporary mechanical circulatory support in patients with refractory heart failure complicated by cardiogenic shock, but its use is generally limited to short-term therapy because of device-related complications.
Case Report (n=1)
No
Demonstrates that prolonged IABP support for up to 293 days is feasible and can serve as an effective bridge to heart transplantation in selected patients when combined with a left subclavian approach, serial device replacement, and multidisciplinary care.
Answers are grounded in this paper and cite their sources.
Supports prolonged IABP as bridge in select refractory HF; leaves open need for prospective safety data before broader adoption.
BACKGROUND: The intra-aortic balloon pump (IABP) is widely used as temporary mechanical circulatory support in patients with refractory heart failure complicated by cardiogenic shock. However, its use is generally limited to short-term therapy because of device-related complications. CASE SUMMARY: A 57-year-old man with idiopathic dilated cardiomyopathy receiving guideline-directed medical therapy and cardiac resynchronization therapy with defibrillation developed cardiogenic shock refractory to inotropic therapy, requiring IABP implantation. Mechanical circulatory support was maintained for 293 days, including 291 days as a bridge to heart transplantation and 2 days after transplantation. DISCUSSION: This case demonstrates that prolonged IABP support is feasible when combined with transition to a left subclavian approach, serial device replacement, and meticulous multidisciplinary management. TAKE-HOME MESSAGE: In carefully selected patients, prolonged IABP support, combined with individualized device management and multidisciplinary care, may provide sustained clinical stabilization and serve as an effective bridge to heart transplantation.
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Bernardes et al. (2026) conducted a case report in Idiopathic dilated cardiomyopathy and cardiogenic shock refractory to inotropic therapy (n=1). Prolonged intra-aortic balloon pump (IABP) support via left subclavian approach with serial device replacement was evaluated on Bridge to heart transplantation and clinical stabilization. Intra-aortic balloon pump support maintained for 293 days (291 days pre-transplant) via a left subclavian approach successfully bridged a refractory cardiogenic shock patient to heart transplantation.
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