Which of the following is a contraindication for an Intra Aortic Balloon Pump?

• A. Hemodynamically significant aortic regurg
• B. Normal aortic valve function
• C. Mild degenerative aortic stenosis
• D. Hypotension

Answer: (A)

Significant aortic regurgitation is a contraindication for an intra-aortic balloon pump because the device inflates the balloon in the aorta during diastole to boost coronary perfusion. In a heart with marked AR, that diastolic inflation increases the pressure driving blood back through the incompetent aortic valve into the left ventricle, worsening regurgitant flow, increasing LV volume load, and potentially worsening overall perfusion. The benefits of diastolic augmentation and afterload reduction rely on a competent aortic valve to direct blood forward; when regurgitation is hemodynamically significant, those effects become harmful rather than helpful.

Normal aortic valve function is compatible with IABP use. Mild degenerative aortic stenosis is not an absolute contraindication, though it may require careful assessment. Hypotension is not a contraindication; IABP is often used to support patients with low blood pressure or cardiogenic shock when not limited by other contraindications.