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Influence of intra-aortic balloon pumping on cerebral blood flow pattern in patients after cardiac surgery

  • A. Schachtrupp (a1), H. Wrigge (a2), T. Busch (a3), W. Buhre (a4) and A. Weyland (a5)...

Abstract

Summary

Background and objective: The effects of intra-aortic balloon pumping (IABP) on cerebral perfusion are still a matter of debate. End-diastolic reversal of blood flow in cerebral arteries has been observed in a small number of patients. We prospectively investigated the incidence and the amount of transient cerebral artery blood flow reversal during balloon pumping in patients recovering from cardiac surgery.

Methods: In 23 patients receiving IABP support, blood flow velocities in the right middle cerebral artery were assessed by transcranial Doppler-sonography. Additionally, systemic haemodynamics were monitored. In each patient, measurements were performed at three different pump settings: without support, assist ratio 1 : 1 and assist ratio 1 : 2.

Results: In 8 of 23 patients, balloon pumping caused a transient diastolic reversal of blood flow in the middle cerebral artery during balloon deflation. Antegrade mean flow velocity in the middle cerebral artery significantly increased from 57 ± 27 to 61 ± 26 (assist ratio 1 : 1) and 61 ± 29 cm s−1 (assist ratio 1 : 2) (P < 0.05). Taking transient blood flow reversal into account, net mean flow velocity did not increase with balloon pump support. Systemic haemodynamic parameters remained unchanged.

Conclusion: Left ventricular support with IABP significantly changed flow patterns in basal cerebral arteries of our patients. In 35% of patients, support resulted in a transient reversal of intracranial blood flow which counterbalanced a slight increase in mean antegrade flow.

Copyright

Corresponding author

Correspondence to: Alexander Schachtrupp, Department of General Surgery, Technical University Aachen, Pauwelsstr 30, D-52074 Aachen, Germany. E-mail: Alexander.Schachtrupp@post.rwth-aachen.de; Tel: +49 241 8089500; Fax: +49 241 8082417

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Keywords

Influence of intra-aortic balloon pumping on cerebral blood flow pattern in patients after cardiac surgery

  • A. Schachtrupp (a1), H. Wrigge (a2), T. Busch (a3), W. Buhre (a4) and A. Weyland (a5)...

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