Understanding Axillary Intra-Aortic Balloon Pump Therapy

An intra-aortic balloon pump (IABP) is a device that helps your heart pump better. It's used most often when your heart is not able to pump enough blood for your body (heart failure). This pump eases the workload on the heart. The therapy may be used when you are waiting for a heart transplant.

An IABP has several parts. One part is a thin, flexible tube (catheter). The catheter is put in a large artery either in your groin or your arm. For the arm version (axillary), the IABP is placed in a large artery in the arm (axillary artery). The tip of the catheter has a long balloon (intra-aortic balloon). The balloon is inserted into the very large artery (aorta) that leaves your heart. The other end of the catheter is outside your body. It attaches to a computer. The computer tells the balloon to fill (inflate) or deflate at the right time when your heart beats.

When the heart relaxes, the balloon inflates. When the heart squeezes (contracts), the balloon deflates. This allows the heart to pump more blood out to the body, but it uses less energy. The device continues to inflate and deflate until it’s removed.

Why axillary IABP is done

Axillary IABP therapy is most often used for a short time to support the heart. Or it's used as a bridge to therapy while waiting for a left ventricular assist device or a transplanted heart. It's used when medicines and other treatments have not worked well.

Waiting for a heart transplant might take a while. Axillary IABP therapy can help your heart pump better during this wait time. It can also help keep you moving. You can sit up, get out of bed, and walk around. That way, when a heart becomes available, you’ll be in better physical shape for the surgery.

How axillary IABP is done

You will likely have the axillary IABP placed in the cardiac cath (catheterization) lab. Most often, the healthcare provider uses the left arm. You will get local anesthesia to numb the skin where the catheter will be placed. You may also get some medicine through an IV line to relax you. You’ll be drowsy but awake.

The provider puts a needle through the skin. Then they thread the catheter into the artery using ultrasound to guide it. X-ray images are then used to place the balloon in the correct position. Once in place, the provider stitches the catheter to the skin and uses a special device to keep it in place. Then, the catheter is connected to the computer. A dressing is placed over the site.

Risks of axillary IABP

Axillary IABP therapy can be very helpful. It can sometimes even be life-saving. But it does have some risks. These include:

• Catheter coming out of position

• Severe bleeding

• Injury to the axillary artery

• Infection

• Damage from the lack of blood flow to the arm (ischemia). This can happen if the tubing and pump block blood flow through the artery they are inserted into. If this is prolonged, it can lead to loss of function of the limb, or the limb itself.

• Nerve injury in the arm

• Balloon rupture

• Stroke

Your risks depend on your age and your overall health. Talk with your healthcare provider about which risks apply to you. Also talk with your provider about any concerns you have. Your family or the person named to make healthcare decisions for you may need to talk with your provider if you are too ill to speak with them.