Lipp Vis Nursing ChaptLWBK1630_C02_p013-068

64  Chapter 2 • Cardiovascular Care

Vena Caval Filter

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.

Left renal vein

Umbrella Direction of blood flow

Inferior vena cava

Mechanical Circulatory Assist (Support) Devices Designed for a wide range of clinical conditions such as prophylactic insertion for high-risk invasive

• Intra-aortic balloon pump (IABP) counterpulsation temporarily reduces left ventricular workload and

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

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.

coronary artery procedures to manage cardiogenic shock, acute decompensated HF, or cardiopulmonary arrest.

Understanding an IABP

Balloon inflated during early diastole

Balloon deflated just

before systole

D I A S T O L E

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