Q: All of the following are indications of Intra-Aortic Balloon Pump (IABP) except?

A)  Acute ischemic cardiogenic shock
B) Acute mitral regurgitation
C) Ventricular septal rupture
D) Left main coronary artery stenosis
E) Severe sepsis


Answer: E

IABP is a life rescuing procedure in hemodynamic instability. Being an intensivist it is of apparent importance to call for IABP if patient develops complications from acute myocardial infarction particularly if ventricular wall rupture or papillary muscle rupture. Absolute contraindication to IABP is aortic regurgitation, aortic dissection, significant aortic aneurysm, severe sepsis, clinically significant bleeding disorder or severe peripheral artery disease to insert IABP. Complications are expected in older and female patients as well as with diabetes, hypertension, requiring more than 9.5F catheter size or smaller body surface area.



Reference: 

Kushner FG, Hand M, Smith SC Jr, et al. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2009; 54:2205.