Aguirre F V, Kern M J, Bach R, Donohue T, Caracciolo E, Flynn M S, Wolford T
Cardiac Catheterization Laboratory, St. Louis University Medical Center, Mo. 63110.
Cardiology. 1994;84(3):175-86. doi: 10.1159/000176396.
Intraaortic balloon pump support has been demonstrated to be of clinical benefit when used therapeutically and prophylactically in high-risk patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Afterload reduction and post-PTCA-enhanced coronary blood flow afforded by diastolic augmentation during intraaortic balloon pumping provides hemodynamic stabilization, attenuates clinical perturbations of myocardial ischemia, and may provide an important 'bridge' to emergent coronary bypass surgery following abrupt vessel closure complicating PTCA. Recent studies demonstrate a reduction in cardiac morbidity and improved coronary artery patency among patients receiving prophylactic intraaortic balloon pumping after establishing infarct artery reperfusion during acute cardiac catheterization for acute myocardial infarction. A modest increase in cardiac output (20-30%), the requirement of a stable, regular cardiac rhythm, peripheral vascular disease and aortic insufficiency limits the use of intraaortic balloon pump support in relatively few patients. These studies demonstrate that intraaortic balloon counterpulsation provides an effective and safe form of mechanical support in many high-risk patients undergoing PTCA.
在接受经皮腔内冠状动脉成形术（PTCA）的高危患者中，经治疗性和预防性使用主动脉内球囊泵支持已被证明具有临床益处。在主动脉内球囊泵入期间，舒张期增压可降低后负荷并增加PTCA后的冠状动脉血流量，从而实现血流动力学稳定，减轻心肌缺血的临床干扰，并可能为PTCA后突然血管闭塞并发紧急冠状动脉搭桥手术提供重要的“桥梁”。最近的研究表明，在急性心肌梗死的急性心导管插入术中建立梗死动脉再灌注后，接受预防性主动脉内球囊泵入的患者心脏发病率降低，冠状动脉通畅性改善。心输出量适度增加（20%-30%）、需要稳定的规则心律、外周血管疾病和主动脉瓣关闭不全限制了主动脉内球囊泵支持在相对较少患者中的使用。这些研究表明，主动脉内球囊反搏为许多接受PTCA的高危患者提供了一种有效且安全的机械支持形式。
