The most obvious indication is to support the circulation where a structural cardiac defect is to be repaired surgically. However, it may be used in acute circulatory failure in any situation where resolution of the cause of the cardiac dysfunction is expected. In acute myocardial infarction, resolution of peri-infarct oedema may allow spontaneous improvement in myocardial function; the use of intra-aortic balloon counterpulsation may provide temporary circulatory support and promote myocardial healing by improving myocardial blood flow. Other indications include acute myocarditis and poisoning with myocardial depressants. Intra-aortic balloon counterpulsation should not be used in aortic regurgitation since the increase in diastolic blood pressure would increase regurgitant flow.

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