Experimental study of extraaortic balloon counterpulsation as a bridge to other mechanical assists.

A special extraaortic balloon was developed that can be placed around the ascending aorta. This balloon can easily support the heart temporarily in a median sternotomy field, especially in cases in which it is difficult to use intraaortic balloon pumping because of peripheral arterial disease. The goal of this study was to judge the applicability of this extraaortic balloon counterpulsation. An extraaortic balloon was placed around the ascending aorta of eight adult canines. Two heart failure models were used in this study: group A-moderate heart failure; group B-severe heart failure. In group A, the aortic systolic pressure was significantly reduced (9.3%, p < 0.01), but in group B, there was no significant change. In group A, there was a significant increase in cardiac output (12.0%, p < 0.01), but in group B, there was no significant change. The endocardial viability ratio in both groups significantly increased (group A: 11.3%, p < 0.01; group B: 11.9%, p < 0.05). An extraaortic balloon around the ascending aorta is easily applicable through a median sternotomy, and can be used as a bridge to more powerful mechanical assists when intraaortic balloon pumping cannot be used.