Improved cardiac assistance with an aortic arch balloon

The haemodynamic effects of intra-aortic counterpulsation with normally used cylindrical and newly designed aortic arch balloons on the coronary blood flow and the performance of the normal dog heart were compared. Both balloon types resulted in a decrease of left ventricular systolic and end-diastolic pressure, systolic arterial and end-diastolic arterial pressure. The amplitude of diastolic augmentation was significantly larger with the aortic arch balloon. The carotid artery flow increased significantly more with the aortic arch balloon (36%) than with the cylindrical balloon. Pulsation in the aortic arch effected a significant decrease in left ventricular impedance (33%), which was inversely correlated with a marked increment of the stroke volume (36%). In addition, mean coronary blood flow increased during aortic arch balloon pulsation (37%). From these data, it is concluded that optimal intra-aortic balloon pulsation should be performed with large balloons close to the aortic valve. The newly designed aortic arch balloon fulfils this condition.