[HSF] Trip to Croatia

[Hgrmd at aol.com]

Prasanna,
  Actually, the pressure in the balloon has no direct relationship  with the 
aortic perfusion pressure.  I know, because I asked the same  question you 
just raised.  It is related to the resistance of the  balloon.  What does have a 
direct relationship to the perfusion pressure is  the aortic root pressure 
which is measured via the distal port of the  balloon.  The pressure in the root 
and the resistance of the balloon  against the aortic wall must be precisely 
counterbalanced by the perfusion  pressure and the mechanical tension produced 
by taking out any slack in the  catheter.  For example, if you abruptly 
dropped the perfusion pressure  while administering antegrade cardioplegia, the 
balloon would tend to migrate  toward the arch.  Conversely, if the aortic root 
pressure was low and  there was slack in the catheter, the perfusion pressure 
would have a  tendency to push the balloon into the ventricle.  I've used this 
balloon  quite a few times over the last 4 months.  It still is one of the most 
 stressful parts of the case.  
 
Hal



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