Afscheid van de intra-aortale ballonpomp?

The intra-aortic balloon pump (IABP) has been a reliable friend in the catheterization laboratory and operating room. This good old friend of the cardiologist and cardiothoracic surgeon is about to disappear from the clinical scene. For more than 5 decades, it has largely been deployed for acute myocardial infarction and cardiogenic shock. Its more recent failure to demonstrate efficacy for cardiogenic shock will herald its demise. It may not disappear completely but its usage will become extremely limited. The lesson we have learned from the IABP history and other therapies is that we should never trust surrogate endpoints such as cardiac (power) output when it comes to cardiogenic shock. Newer devices should be tested in properly randomized controlled clinical trials before worldwide adoption.

Conflict of interest and financial support: there are interests declared. The AMC Heart Centre, where both authors are employed, received financial support from Abiomed, the manufacturer of the Impella pump. A disclosure form provided by the authors is available with the full text of this article at www.ntvg.nl, search for A5936; click on ‘Belangenverstrengeling’ (‘Conflict of interest’).