It is told of the late Charles Boyer that when he was aged and ailing, he had a ready answer to all inquiries about the state of his health. "Not good," he would concede, "but not too bad, considering the alternative."
A similar reply could well be given to inquiries about the status of the intra-aortic balloon counterpulsation (IABCP) in the treatment of shock complicating myocardial infarction. Considering the alternative of mortality approaching 100% in patients refractory to conventional medical treatment, the results of the IABCP assistance, however unimpressive statistically, are clearly not "too bad."
When Kantrowitz et al1 reported in The Journal the first use of IABCP in cardiogenic shock, expectations ran high. The principle of this device, suggested earlier by Moulopoulos et al,2 is physiologically sound. Inflation in diastole of a balloon catheter placed at the top of the descending aorta increases coronary perfusion by augmenting the
Vaisrub S. Intra-aortic Balloon Counterpulsation— A Versatile Assist. JAMA. 1978;239(5):437. doi:10.1001/jama.1978.03280320053025
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