Case Report

Enhanced Augmentation of Cardiac Output for Different Counterpulsation
Modes Using a New Intra-Aortic Balloon
and Catheter

Catalin Boiangiu, MD, Fellow, Division of Cardiology,
Newark Beth Israel Medical Center, Newark, NJ; and Marc
Cohen, MD, Chief, Division of Cardiology; Director, Cardiology
Fellowship, Newark Beth Israel Medical Center, Newark,
New Jersey and Professor of Medicine, Mount Sinai School of
Medicine, New York, New York

Abstract
We report the enhanced augmentation of cardiac output in a 60-year-old man who underwent percutaneous coronary intervention with drug-eluting stent implantation for a large anteroseptal ST-segment-elevation myocardial infarction. Because of persistent systemic hypotension during the procedure, a 50cc, 8Fr. Mega™ intra-aortic balloon was inserted, used for 24 hours, and removed without complications. The use of this new balloon — with larger blood volume displacement but smaller caliber at the insertion site — significantly increased cardiac output in 1:1, 1:2, and 1:3 assist modes, by more than 15%, 9%, and 4%, respectively. These findings exceed the average augmentations reported for smaller-volume balloon catheters.