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Arch Hellen Med, 32(4), July-August 2015, 433-440


Advances in intra-arterial counterpulsation: The role of in vitro studies

D.A. Vrachatis, T.G. Papaioannou, M. Vavuranakis, D. Tousoulis
Biomedical Engineering Unit, First Department of Cardiology, National and Kapodistrian University of Athens, "Hippokration" General Hospital, Athens, Greece

Intra-aortic balloon pump (IABP) devices were introduced in clinical practice in the 1960's. The fundamental function of the IABP is aortic counterpulsation. The IABP is utilized mainly to support patients in post myocardial infarction cardiogenic shock and as an adjunctive treatment during high risk cardiac surgery. An increase in the diastolic blood pressure, which results in increased coronary artery perfusion, is the major pathophysiological benefit derived from IABP utilization. End-diastolic aortic pressure is reduced, with a subsequent decrease in left ventricular afterload. Additionally, systolic aortic pressure is decreased, resulting in reduced left ventricular systolic work. In vitro experimental studies have played a crucial role in the investigation, optimization and confirmation of these beneficial effects of IABP. Special experimental models, known as "mock circulation systems" (MCS), are widely used for the in vitro study of artificial organs. Such experimental set-ups may refer either to simple models of non-pulsatile flow or to complex models offering a more realistic simulation of human circulation, which may include pulmonary as well as systemic circulation, and auto-regulatory mechanisms of circulation. The exact specifications of these systems depend on the specific investigational objectives. This is a review of the major advances in the function and efficacy of IABPs that have been derived from in vitro studies.

Key words: Intra-aortic balloon pump, Intra-arterial counterpulsation, In vitro studies, Left ventricular assist devices.

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