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Ann Thorac Surg 1992;53:604-610
© 1992 The Society of Thoracic Surgeons

Articles

Effects of intraaortic balloon position on renal artery blood flow

Marc T. Swartz, BA*, Tohru Sakamoto, MD, Hirokuni Arai, MD, Jane E. Reedy, RN, Luis Salenas, MD, Toshiyuki Yuda, MD, John W. Standeven, PhD, D.Glenn Pennington, MD

Departments of Surgery and Pathology, St. Louis University Medical Center, St. Louis, Missouri, USA

Accepted for publication August 26, 1991.

* Address reprint requests to Mr Swartz, Department of Surgery, St. Louis University Medical Center, 3635 Vista Ave at Grand Blvd, PO Box 15250, St. Louis, MO 63110-0250.

Debate continues over what happens to renal blood flow when intraaortic balloons are adjacent to the renal arteries. Fourteen dogs were prepared by implanting instruments to measure heart rate; right atrial, pulmonary arterial, carotid arterial, and femoral arterial pressures; cardiac index; mixed venous oxygen saturation; urine output; and left and right renal blood flows. A 12-mL intraaortic balloon was inserted through the left (n = 9) or right (n = 5) femoral artery. The position of the balloon was randomized so that it was initially placed in either the control (thoracic) or renal position (at the level of the renal arteries). Intraaortic balloon pumping was performed for 4 hours in each position. In 8 dogs, at least one of the renal arteries had partial occlusion, 23% to 98% decrease in flow (mean decrease, 66%), while the intraaortic balloon was in the renal position. An intraaortic balloon in the renal position results in lower renal blood flow as well as a high risk (57%) of selective renal artery occlusion. Decreased renal blood flow is not apparent using conventional monitoring, as hemodynamics do not change.




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