J.Jpn. Surg. Soc.. 80(12): 1554-1557, 1979

---

Report on the annual meeting

A NEW MECHANISM IN THE EFFECT OF THE INTRAAORTIC BALLOON PUMPING FOR THE TREATMENT OF CARDIOGENIC SHOCK

The intraaortic balloon pumping (IABP) is now widely used as an effective adjunct intervention to medical and surgical treatment of cardiogenic shock mostly secondary to acute myocardial infarction, postsurgical acute heart failure, inability to wean from cardiopulmonary bypass or other deteriorated circulatory condition.
The mechanisms of the effect of IABP have been explained as follows: (1) Augmentation of the coronary artery blood flow during the ventricular diastole and (2) Unloading of the left ventricular afterload during the systole resulting in the left ventricular endodiastolic pressure fall.
In this report a new finding of the predictive phenomenon of the carotid sinus baroreceptor response to the diastolic IABP is described as another possible mechanism of the improving effect of cardiocirculatory dynamics associated with IABP.
In the mongrel dog, the firing impulses were recorded from the carotid sinus nerve during IABP. The burst of impulses was initiated by the diastolic rise in the carotid arterial pressure during IABP, but fewer impulses were observed during systole and very few impulses during diastole. The integrated carotid sinus nerve activity was demonstrated, in which an apparent increase in activity was demonstrated during IABP.
The carotid arterial pressure, blood flow and venous pressure were also recorded simultaneously. The calculated carotid arterial, femoral arterial and systemic vascular resistance was significantly lowered.
In a 59-year-old male patient with aortic insufficiency, who was operated on aortic valve replacement with the porcine xenograft, the IABP was performed for the improvement of his immediate postoperative cardiocirculatory function with the result of lowering the systemic vascular resistance and heart rate, with which his postoperative course was uneventful.
In summary, with the rapid increase in blood pressure of the carotid sinus, IABP might act to inhibit the vasoconstrictor activity and to diminish the accelerating heart rate activity by a reflex mechanism resulting in the peripheral vasodilation and in the lowering heart rate in the mal-circulatory state.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.