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October 1981

Ventricular Failure-Reply

Arch Intern Med. 1981;141(11):1558. doi:10.1001/archinte.1981.00340120166049

—We agree that use of intra-aortic balloon counterpulsation has already been reported in isolated right-sided heart failure. Lorell et al1 and Jensen et al2 used counterpulsation in patients with right ventricular infarction complicated by shock and right ventricular failure and showed that it resulted in decreased left ventricular filling pressure but did not substantially change the cardiac index or right-sided pressures. Our article focused on the treatment of right ventricular infarct with shock, with special emphasis on the improvement of right and left ventricular function by dobutamine therapy and counterpulsation. Our patient's condition was different from that of the patient described by Kopman and Ramirez-Inawat,3 in that they reported isolated right ventricular failure with temporary dysfunction of the right ventricle. No cause was reported in their study.

The pulmonary wedge pressure in our patient was 17 mm Hg (not the left ventricular end-diastolic pressure as Kopman stated). This

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