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21
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IAB Insertion / CARDIOSAVE Operation
|
Cardiac Assist
|
timing Errors
Early Deflation
Premature deflation of IAB during
diastolic phase.
Waveform characteristics
•
Deflation of IAB is seen as a sharp
drop following diastolic augmentation
•
Sub-optimal diastolic augmentation
•
Assisted end diastolic pressure may be
equal to or less than unassisted end
diastolic pressure
•
Assisted systolic pressure may rise
Late Deflation
Deflation of IAB after aortic valve has
opened.
Waveform characteristics
•
Assisted end diastolic pressure may
be equal to or higher than unassisted
end diastolic pressure
•
Rate of rise of assisted systole
is prolonged
•
Diastolic augmentation may appear
widened
Physiologic Effects
•
Sub-optimal coronary perfusion
•
Potential for retrograde coronary
and carotid blood flow
•
Angina may occur as a result of
retrograde coronary blood flow
•
Sub-optimal afterload reduction
•
Increased MVO
2
demand
Physiologic Effects
•
Afterload reduction is essentially
absent
•
Increased MVO
2
consumption
due to left ventricle ejecting
against a greater resistance and
a prolonged isovolumetric
contraction phase
•
IAB may impede left ventricular
ejection and increase afterload
Unassisted End
Diastolic Pressure
Diastolic
Augmentation
Assisted
Systole
Assisted End
Diastolic Pressure
Unassisted End
Diastolic Pressure
Assisted End
Diastolic Pressure
Diastolic Augmentation
CARDIOSAVE
OPERATION
