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Chapter 2
•
Cardiovascular Care
Vena Caval Filter
A vena caval filter, or umbrella, traps
emboli originating from the pelvis
or lower extremities in the vena
cava, preventing them from reaching
the pulmonary vessels but allowing
venous blood flow.
Vena Caval Filter
Umbrella
Direction
of blood
flow
Left renal vein
Inferior vena cava
Understanding an IABP
D I A S T O L E
Balloon
inflated
during
early
diastole
The balloon deflates rapidly at the end of diastole, creating a vacuum in
the aorta. This reduces aortic volume and pressure, thereby decreasing the
resistance to left ventricular ejection (afterload). This decreased workload,
in turn, reduces the heart’s oxygen requirements and, combined with the
improved myocardial perfusion, helps prevent or diminish myocardial
ischemia.
S Y S T O L E
Balloon
deflated
just
before
systole
Mechanical Circulatory Assist
(Support) Devices
Designed for a wide range of clinical
conditions such as prophylactic
insertion for high-risk invasive
coronary artery procedures
to manage cardiogenic shock,
acute decompensated HF, or
cardiopulmonary arrest.
These devices include:
•
Intra-aortic balloon pump (IABP)
•
The intra-aortic balloon pump
(IABP) is the most commonly
used mechanical support device
•
These devices are often placed
in the catheterization laboratory
but in some cases, can be placed
in intensive care unit.
•
Intra-aortic balloon pump
counterpulsation
•
Intra-aortic balloon pump
(IABP) counterpulsation
temporarily reduces left
ventricular workload and
improves coronary perfusion.
It is used to treat cardiogenic
shock caused by acute MI, septic
shock, intractable angina before
surgery, intractable ventricular
arrhythmias, ventricular septal
or papillary muscle ruptures,
and pump failure.