Intra-aortic balloon counterpulsation 50 years later: initial conception and consequent ideas.

For nearly 50 years, intra-aortic balloon counterpulsation (IABC) has been the most widely applied temporary assistance method, operating in series with the heart. It helps wean patients from the heart-lung machine after cardiac operations. It is also used in patients with advanced coronary heart disease before and during cardiac and noncardiac operations as well as during percutaneous interventions. Cases of post-acute myocardial infarction severe cardiogenic shock can also benefit from IABC until or during revascularization or if the latter is impractical. A brief review of mostly experimental attempts is reported as "derivatives" of IABC, as they yielded interesting and sometimes intriguing results that need further investigation.