Inability to wean from cardiopulmonary bypass following cardiac surgery despite adequate inotropic support and left ventricular filling, particularly after myocardial revascularization, is one of the most common indications for IABP. Other indications include unstable angina that is not responsive to medical treatment, acute myocardial infarction, particularly when associated with post-infarction complications such as left ventricular failure, papillary muscle rupture, and ventricular septal rupture. IABP is also indicated in the failing heart following transplantation and in patients with viral myocarditis. Occasionally IABP is used prophylactically in cardiac surgery for patients with very poor left ventricular ejection fraction prior to myocardial revascularization. It is sometimes used prophylactically in patients about to undergo high-risk angioplasty.

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