CHARACTERIZATION OF INTRAAORTIC BALLOON PUMP (IABP) TIMING ERRORS USING AN ADULT CARDIOVASCULAR SIMULATOR

Abstract

We have hypothesized that sources of IABP ineffectiveness are inflation and deflation timing errors due to delays and distortions of the arterial waveform obtained through the fluid-filled lumen of the IABP catheter. Recent human and animal data have confirmed the existence of these errors. Investigating ways to reduce or eliminate these errors and the consequence of the errors may be difficult, if not unacceptably risky, to undertake in human experiments. A controlled, safe and more versatile approach to this problem has been to introduce an adult IABP catheter into the aorta of an adult circulation simulator system. The simulator consists of a pneumatically actuated ventricular sac with trileaflet mitral and aortic valves that approximates the geometry and contraction of the human left ventricle. The instrumented ventricle ejects into instrumented resistance and compliance elements that can be adjusted to create physiologic pressure and flow conditions for the normal and failing left ventricle. The influence of arterial pressure monitoring technique on IABP inflation and deflation timing landmark location and the resulting changes in hemodynamics can be compared along with investigations on the effect of pressure extension line length, bubbles in the fluid line, the size of IABP balloon, the size of the IABP catheter lumen, IABP synchronization rate, and differences in timing strategy.