Effects of intraaortic balloon pumping on mitral flow dynamics in patients with coronary artery bypass operations.

We evaluated the improvement in left ventricular function in 26 patients after coronary artery bypass grafting who were treated with intraaortic balloon pumping (IABP). Mitral flow velocity-time integral in the rapid filling phase (IntR) and that in the atrial contraction phase (IntA), the sum of IntR and IntA (IntR+IntA), and the ratio of IntA to IntR (IntA/IntR) were calculated with patients on and off balloon pumping (IABP ON-OFF test). IABP increased IntR and IntR+IntA, decreased IntA/IntR, and did not change IntA, suggesting that a decreased afterload or augmented coronary perfusion improves left ventricular relaxation. When the balloon inflated on every other beat (IABP 1:2 test), IntR and IntR+IntA increased without balloon assist, IntA/IntR decreased off IABP, and IntA did not change. The afterload reduction or augmented coronary perfusion on the previous beat with IABP might help ventricular filling on the next beat without balloon assist. A drastic decrease in IntR after IABP stopped indicated the need to continue IABP. Since the change in IntR during IABP ON-OFF test was significantly correlated with that in IntR during IABP 1:2 test, the change in IntR during IABP 1:2 test could help to predict the optimal time of weaning.