An axillary intra-aortic balloon pump (IABP) is a device that helps your heart pump. You may need it if your heart is not able to pump enough blood for your body. An axillary IABP improves blood flow to the coronary arteries and into the heart muscle and to the rest of the body. With better blood flow, the pressure the heart has to pump against is less. So, the heart doesn't have to work as hard to get blood out to the body.

This procedure is done through a large I.V. (intravenous) line placed in your upper arm. Your doctor will place the balloon pump catheter into an artery in that area. They will guide it to your aorta. The device has a balloon. This balloon fills up (inflates) when your heart relaxes. This helps increase blood flow to the heart muscle and coronary arteries. When the heart squeezes, the balloon shrinks (deflates). This allows more blood to flow forward out to the rest of the body.

This therapy may be used when you have severe heart failure or cardiogenic shock. It may be used as a bridging support device while waiting for a heart assist device or even a heart transplant. It is routinely used with other medicines to improve heart function. This procedure is not done in an outpatient setting. Anyone with a balloon pump needs to be closely monitored in an intensive care unit.

Before your procedure, your doctor will give you detailed instructions. You may need to stop taking some medicines before the procedure. You may also be given some new medicine to take before and during the treatment. This may include medicine to help prevent blood clots.

Axillary IABP is most often done in the cardiac cath (catheterization) lab. Each person's procedure can vary. Your doctor can tell you what to expect. In general, you can expect the following:

• You may get local anesthesia to numb the skin where the catheter will be placed.
• You may also get some medicine through an I.V. line to relax you. You'll be drowsy but awake.
• During the procedure, your heart rate, blood pressure, pulses, and other vital signs will be watched.
• The doctor will put an I.V. line into an artery in the upper part of your arm. The balloon catheter will be placed there.
• The doctor will gently push the catheter to a part of the aorta in your chest. They will use X-ray images or ultrasound to watch the movement of the catheter.
• The catheter will be connected to a computer outside of your body. The balloon will be set to inflate when your heart relaxes. It will deflate when your heart squeezes.
• The doctor will attach the end of the catheter using stitches and a special device so it stays in place.

When the procedure is done, you will go to the intensive care unit where you will be closely watched. How long you have the pump depends on why you are having it. For example, if you are waiting for a heart transplant, it may take some time before a heart becomes available. Your doctor will be able to give you more information.

You may get blood-thinning medicines to keep blood clots from forming on the catheter and balloon. Blood flow in your arm, pump function, and the insertion site will also be watched very closely. That's to help make sure no complications happen because of the therapy.

Complications may include:

• Poor blood flow through the artery or the arm where the pump is placed. This can cause damage to or loss of limb.
• Stroke
• Damage to blood vessels during insertion or inflation
• Balloon moving out of position
• Balloon not working correctly
• Balloon breaking
• Bleeding
• Infection
• Death

Let your doctor know right away if you see any bleeding from the catheter site or feel any numbness, tingling, pain, or changes in your arm or shoulder.

Your doctor will let you know when it's time to remove the pump. You may also get more instructions. Follow these carefully to help increase your chance of a good outcome.