Technical Seminar for Intra-aortic Balloon Pumping

System 98/98XT

Datascope Clinical Support Services

TECHNICAL SEMINAR
Course Description
This four hour presentation is designed for health care professionals with previous IABP
experience. The program begins with a brief review of the theory of intra-aortic balloon pumping
and a discussion of the percutaneous IAB. The technical aspects of the Datascope IABP will then
be discussed in detail highlighting troubleshooting in the clinical setting. A limited skills
workshop using the Abbreviated Operator s Guide and Performance Checklist will be provided.

Behavioral Objectives
At the conclusion of this program, the participants will be able to:
1. Define the two physiological effects achieved by the mechanics of inflation and deflation of
the IAB as it relates to the cardiac cycle illustrated by an augmented arterial pressure waveform.
2. Identify four indications and three contraindications for IABP therapy.
3. Identify the major complications associated with IABP therapy.
4. Discuss the operation and troubleshooting of the Datascope IABP utilizing the Abbreviated
Operator s Guide and Performance Checklist.

Datascope Corp. 1998

Course Schedule

8:00-8:10

Introduction/Program Review

8:10-9:10

Theory of IABP
A. Effects
B. Indications
C. Contraindications
D. Side Effects/Complications

9:10-9:30

IAB Catheter Presentation

9:30-10:00

Break

10:00-11:00

Technical Components of the System

Set-up demonstration
Review Abbreviated Operator s Guide

11:00-11:50

Troubleshooting
Hands-on Skills Workshop

11:50-12:00

Evaluation

I.

Theory of IABP
A. Counterpulsation
1. Balloon Structure and Position
2. Increased Coronary Perfusion
a. Inflation
b. Augmentation of Diastolic Pressure
3. Decreased Left Ventricular Workload
a. Deflation
b. Afterload Reduction
4. Physiological Pressure Wave Changes
a. Dicrotic Notch
b. Diastole: Augmentation
c. Decreased End-Diastolic Pressure
d. Systole: Decreased Assisted Systolic Pressure

ARTERIAL WAVEFORM VARIATIONS DURING IABP THERAPY

1:1 IABP Frequency

1:2 IABP Frequency

1:3 IABP Frequency

B.

D.

Indications
1.

Refractory ventricular failure

2.

Cardiogenic shock

3.

Unstable refractory angina

4.

Impending infarction

5.

Mechanical complications due to acute myocardial infarction, i.e., ventricular

septal defect, mitral regurgitation or papillary muscle rupture.

6.

Ischemia related intractable ventricular arrhythmias

7.

Cardiac support for high risk general surgical patients and coronary
angiography/angioplasty patients

8.

Septic shock

9.

Weaning from cardiopulmonary bypass

10.

Intraoperative pulsatile flow generation

11.

Support for failed angioplasty and valvuloplasty

Contraindications
1.

Severe aortic insufficiency

2.

Abdominal or aortic aneurysm

3.

Severe calcific aorta-iliac disease or peripheral vascular disease

4.

Sheathless insertion with severe obesity, scarring of the groin, or other

contraindications to percutaneous insertion

Please Refer to the Instructions for Use Prior to Insertion of the IAB

D. SIDE EFFECTS AND COMPLICATIONS OF IABP THERAPY

Assessment

Prevention

Treatment Options

1. Limb Ischemia

` Check distal pulses, color, temp.

and capillary filling Q30 min x
2 hrs, then Q2 hrs.
` Monitor differential toe
temperatures.

` Use smallest sheath/catheter

sizes indicated.
` Risk factors: female, diabetics,
peripheral vascular diseases.
` Select limb with best pulse.

` Remove sheath and observe for

bleeding.
` Subcutaneous Xylocaine
injection for arterial spasm.
` Change insertion site to
opposite limb.
` Bypass graft femoral artery.

2. Excessive bleeding from

insertion site

` Observation - anteriorly and

posteriorly for blood or
hematoma.

` Careful insertion technique.

` Monitor anticoagulation
therapy.
` Prevent catheter movement at
insertion site.

` Apply pressure. Assure distal

flow.
` Surgical repair.

3. Thrombocytopenia

` Daily platelet count.

` Avoid excessive heparin.

` Replace platelets as needed.

4. Immobility of balloon catheter.

` DATASCOPE
RECOMMENDS THAT
THE IAB NOT BE LEFT
IMMOBILE IN THE
PATIENT FOR MORE
THAN 30".
` Observation of IAB status
indicator movement.
` Observation of augmentation.

` Maintain adequate trigger.

` Observe movement of IAB
Status indicator.
` If unable to inflate the IAB
with the IABP, inflate and
deflate the IAB by hand, using a
syringe and stopcock once every
3-5 min.

` Notify the physician if the IAB

is immobile for > 30".

Assessment

Prevention

Treatment Options

5. Balloon leak

` Observe tubing for blood

with or without the presence
of a blood detect, low
augmentation, and/or gas loss
or IAB catheter alarm.

` Do not remove the IAB from

its tray until it is ready to be
inserted.

` If blood is observed in the

pneumatic tubing, disconnect
the balloon from the IABP
and notify the physician
immediately.

6. Infection

` Observation of insertion site.

` Blood cultures for symptoms
of infection.

` Sterile technique during

insertion and dressing
changes as per infection
control policy.

` Antibiotics.

7. Aortic Dissection

` Assess for pain between

shoulder blades.
` Daily hematocrit.
` If suspected, aortogram may
be indicated.

` Insertion of IAB over guide

wire with fluoroscopic
control.

` Balloon removal.
` Surgical repair.

8. Compartment syndrome may

develop after IAB removed.

` Observation of limb for

swelling and/or hardness.
` Measure calf girth.
` Monitor interstitial pressure.

` Use the smallest catheter/

sheath appropriate.
` Maintain adequate colloid
osmotic pressure.

` Fasciotomy if necessary.

II. Intra-aortic Balloon Catheter

Designed for sheathless or sheathed insertion.

10

III. Technical Components of the System 98/98XT Intra-Aortic Balloon Pump

11

This page intentionally left blank.

12

A. Rear Panel
1. Safety Disk/Condensate Removal
System
a. DC Input
b. IAB Fill Port
c. Drain Port
2. Helium Supply
a. Pressure Gauge
b. Manual Fill Port
3. Patient Connections
a. ECG
b. Pressure
c. Monitor Input
d. ECG/Pressure Output
4. Data Communications Outputs
a. RS-232
b. Phone Line
c. Diagnostic Output
5. Power Cord/Mains
a. Auxiliary DC Input
6. System Timer

13

B. Monitor 98/98XT
1. Alarm Messages

5. IAB Status Indicator

2. Advisories

6. Trigger

3. ECG

7. Heart Rate Display

a. Lead

8. Pressure Display

b. Gain

9. Augmentation Alarm

4. Pressure

10. Helium Indicator

a. Source

11. Battery Indicator

b. Scale
14

System 98 Key Pad

C. Control Panel
1. Auxiliary

3. Patient Waveforms

a. ECG Gain

a. ECG Lead/Ext.

b. Pressure Threshold

b. Pressure Source

c. Internal Rate

c. Inflation Interval

2. Override

d. Freeze Display

a. Slow Gas
b. IAB Fill Mode
c. Timing
Auto/Manual System 98
Auto

Auto Mode System 98XT

R-Trac On
R-Trac Off Manual

Manual

15

System 98XT Keypad

C. Control Panel (Continued)
4. User Options
a. Ref Line
b. Aug Alarm
c. Alarm Volume
d. Help Screen
e. Preferences Menu
f. Printer Menu
g. Print Strip
h. Zero Pressure
i. Alarm Mute

16

System 98 Keypad

System 98XT Keypad

D. IABP Controls
1. Trigger Select

2. IAB Frequency

a. ECG

3. IAB Augmentation

b. Pressure

4. IAB Fill

c. Internal

5. Assist/Standby

d. Pacer V/AV

6. IAB Inflation

e. Pacer A

7. IAB Deflation
17

E. Recorder
1. ECG
2. Pressure
3. Balloon Pressure Waveform

18

4. Heart Rate Trend

5. Blood Pressure Trend

F. System Battery
1. Charge Status
2. Portable Operation

G. Doppler Storage

19

The inflation marker shows the period of inflation. Vertical timing marks located below the
arterial waveform are also available to aid with initial timing.

A unique automatic timing algorithm allows effective balloon pumping even during atrial
fibrillation. Press the Inflation Interval key to observe the period of inflation while pumping.
Vertical markers located below the arterial waveform and the highlighted portion indicates the
period of balloon inflation.

20

IV. Set-Up Demonstration

V. Review Abbreviated Operators Guide

21

VI. Troubleshooting
A. Alarm Messages
1. Trigger Alarms
a. No Trigger
b. No Pressure Trigger
c. No Pressure Trigger - Zero Transducer
d. Trigger Interference
e. Check Pacer Timing
2. Catheter Alarms
a. Leak in IAB Circuit
b. Rapid Gas Loss
c. IAB Disconnected
d. Check IAB Catheter
e. Blood Detected
f. Autofill Failure - No Helium
g. Autofill Failure
h. Autofill Required
3. Pneumatic Alarms
a. High Drive Pressure
b. Low Vacuum
4. System Surveillance Alarms
a. Electrical Test Fails Code # ________________
b. System Failure
c. Safety Disk Test Fails

22

B.

Advisory
1. Alert Messages
a. Augmentation Below Limit Set
b. Irregular Trigger
c. Heart Rate Low
d. Low Helium
e. Low Battery
f. Low Battery (EXT)
g. ECG Detected
h. Prolonged Time in Standby
i.

Maintenance Required Code # ______________

j.

No Patient Status Available

2. Status Messages
a. System Trainer
b. System Test OK
c. Autofilling
c. R-Wave Deflate
e. Auto R-Wave Deflate (System 98XT only)
f. Leak Testing Safety Disk
g. Slow Gas Loss Override On
h. Gas Loss and Catheter Alarms Disabled
i.

Battery in Use

j.

Battery in Use (EXT)

23

3. Prompt Messages
a. IAB Not Filled
b. Unplug Disk Outlet
c. Plug Disk Outlet
d. Manual Fill IAB

C. Patient Conditions
1. Atrial Fibrillation
2. Ectopics
3. Cardiac Arrest
4. Cardioversion/Defibrillation

D. Changing Helium Tank

E. Safety Disk Leak Test
F. Manual Fill
G. Manual Timing

24

H. Factors Affecting Diastolic Augmentation

1. Patient Hemodynamics
a. Heart Rate
b. Stroke Volume
c. Mean Arterial Pressure
d. System Vascular Resistance
2. Intra-Aortic Balloon
a. IAB in Sheath
b. IAB Not Unfolded
c. IAB Position
d. Kink in IAB Catheter
e. IAB Leak
f. Low Helium Concentration
3. IABP
a. Timing
b. Position of IAB Augmentation Control

25

I.

TIMING
TIMIN G ERRORS
1. Early Inflation
Inflation of the IAB prior to aortic valve closure
Waveform Characteristics:
` Inflation of IAB prior to dicrotic notch
` Diastolic augmentation encroaches onto
systole (may be unable to distinguish)
Physiologic Effects:
` Potential premature closure of aortic valve
` Potential increase in LVEDV and LVEDP or PCWP
` Increased left ventricular wall stress or afterload
` Aortic Regurgitation
` Increased MVO2 demand

2. Late Inflation
Inflation of the IAB markedly after closure
of the aortic valve
Waveform Characteristics:
` Inflation of the IAB after the dicrotic notch
` Absence of sharp V
` Sub-optimal diastolic augmentation
Physiologic Effects:
` Sub-optimal coronary artery perfusion

26

3.

Early Deflation
Premature deflation of the IAB
during the diastolic phase
Waveform Characteristics
` Deflation of IAB is seen as a sharp
drop following diastolic augmentation
` Sub-optimal diastolic augmentation
` Assisted aortic end diastolic pressure
may be equal to or less than the
unassisted aortic end diastolic pressure
` Assisted systolic pressure may rise
Physiologic Effects:
` Sub-optimal coronary perfusion
` Potential for retrograde coronary and
carotid blood flow
` Angina may occur as a result of retrograde
coronary blood flow
` Sub-optimal afterload reduction
` Increased MVO2 demand

4. Late Deflation
Waveform Characteristics:
` Assisted aortic end-diastolic pressure may
be equal to the unassisted aortic end
diastolic pressure
` Rate of rise of assisted systole is prolonged
` Diastolic augmentation may appear widened
Physiologic Effects:
` Afterload reduction is essentially absent
` Increased MVO2 consumption due to the
left ventricle ejecting against a greater
resistance and a prolonged isovolumetric
contraction phase
` IAB may impede left ventricular
ejection and increase the afterload

27

J.

Normal Balloon Pressure Waveform

28

Variations in Balloon Pressure Waveforms

Variations in balloon pressure waveforms may be due to the following conditions:

1. Heart Rate
Bradycardia
Increased duration of
plateau due to longer
diastolic phase

Tachycardia
Decreased duration of
plateau due to shortened
diastolic phase.

2. Rhythm
Varying R-R intervals
result in irregular plateau
durations.

3. Blood Pressure
Hypertension
Increased height or
amplitude of the
waveform.

Hypotension Decreased
height or
amplitude of the
waveform.

29

4. Gas Loss
Leak in the closed system
causing the balloon pressure
waveform to fall below
zero baseline. This may be
due to a loose connection,
a leak in the IAB catheter, H2O condensation
in the external tubing, or a patient who is
tachycardiac and febrile which causes increased
gas diffusion through the IAB membrane.

5. Catheter Kink
Rounded balloon pressure
waveform, loss of plateau
resulting from a kink or
obstruction of shuttle gas.
This may be caused by a
kink in the catheter tubing,
improper IAB catheter position, sheath not
being pulled back to allow inflation of the IAB,
the IAB is too large for the aorta, the IAB is not
fully unwrapped, or H2O condensation in the
external tubing.

6. Sustained Inflation
Theoretical possibility if the
IAB remains inflated longer
than 2 seconds. System 90
Series intra-aortic balloon
pump will activate the
System Failure alarm and
deflate the IAB.

30

VII.

Skills Workshop (optional)

A.

Hands-on Time

B. Performance Checklist

31

Datascope System 98/98XT IABP Performance Checklist

Name:

Date:

Date and initial the following as completed:

Review of hospital policy and procedures:
Attends IABP Seminar:
Written exam taken:

Score:

For the following: indicate 1 for Satisfactory, 2 for Repeat Performance Necessary.
System Trainer

Initial Set Up
Establish Power, verify Mains power switch On & IABP
On/Off switch ON
Establish Gas Pressure
Establish ECG and Pressure
Zero Transducer
Confirm Initial Control Settings
a. IABP controls
b. Auxiliary controls
c. Override controls
Initial Timing
Identify and Adjust Inflate Point
Identify and Adjust Deflate Point
Preload Balloon
a. Attach IAB to appropriate connector
b. Attach connector to safety disk/condensate
removal module
c. Initiate autofill cycle
Fill the IAB Catheter and Initiate Pumping
a. Press Assist/Standby - observe for the
message

Autofilling

b. Verify optimal augmentation

c. Fine tune timing
d. Assess hemodynamic benefits
1. augmentation
2. afterload reduction
e. Record pressures
1. assisted
2. unassisted

32

Clinical

Instructor
Initials

TROUBLESHOOTING
For the following sections indicate 1 for SATISFACTORY OR 2 FOR REPEAT
PERFORMANCE NECESSARY:
NECESSARY
SCORE:
A. TRIGGER - DEMONSTRATES ABILITY TO IDENTIFY VARIABLE
TRIGGER SELECTION CRITERIA AND APPROPRIATE USE OF EACH
TRIGGER
WHICH TRIGGER IS THE MOST APPROPRIATE FOR:
1.
2.
3.
4.
5.
6.
7.
8.
9.

Atrial Fibrillation
Demand Ventricular Pacemaker, Rate 60
AV sequential pacemaker, demand mode
Unobtainable ECG signal, regular rhythm, BP 100/50
Cardiac arrest with good chest compressions
Sinus Tachycardia
Sinus Rhythm with frequent PVC'S
Fixed rate AV sequential pacemaker
Atrial pacemaker - 100% paced

B. IAB CATHETER - DEMONSTRATES UNDERSTANDING OF

SITUATIONS THAT MAY CAUSE AN IAB CATHETER ALARM AND
DESCRIBES APPROPRIATE INTERVENTION
DESCRIBE WHY THE FOLLOWING SITUATIONS MAY CAUSE AN IAB
CATHETER ALARM
1. Pt. sitting straight up in bed
2. IAB has not exited the sheath
C. GAS LOSS - IDENTIFIES AND
AN D RECOMMENDS APPROPRIATE
ACTION FOR POTENTIAL LOSS OF HELIUM
1. What does blood in the IAB catheter shuttle gas tubing indicate?
2. Describe the nursing considerations that would be involved
3. What status message would appear if the IAB catheter became disconnected from
the console?

33

D. DEMONSTRATES UNDERSTANDING OF THE HEMODYNAMIC

RELATIONSHIP BETWEEN THE PATIENT AND IABP THERAPY
DESCRIBE WHY THE FOLLOWING FACTORS WOULD CAUSE THE
DIASTOLIC AUGMENTATION ALARM TO SOUND:
1.
2.
3.
4.
5.

Increased heart rate

Decrease in patient stroke volume
Ectopy
Increase in patient BP
Decreased SVR

E. TIMING - RECOGNIZES, INDICATES POTENTIAL CLINICAL

IMPLICATIONS AND DEMONSTRATES APPROPRIATE INTERVENTION
FOR THE FOLLOWING:
1.
2.
3.
4.

Early inflation
Late inflation
Early deflation
Late deflation

F. MISCELLANEOUS
a.

PORTABLE OPERATION:
1. Initiates and terminates portable operation
2. Identifies location of battery charge light

b.

SLAVE CABLES: (IF APPLICABLE)

1. Identifies location and use of ECG and/or pressure cables
2. Describes proper use of ECG slave cable in the presence of pacemakers

INSTRUCTOR SIGNATURE:
COMMENTS:

34

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Guyton, A.C., Textbook of Medical Physiology, Seventh Edition; W.B. Saunders Company, Philadelphia,
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Kinney, M.R.; Dear, C.B.; Packa, D.R.; Voorman, D.N., AACN's Clinical Reference For Critical Care
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Quaal, S.J., Comprehensive Intra-aortic Balloon Pumping, CV Mosby Company, St.Louis, 2nd Edition
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35

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36

George, Barry S., Thrombolysis and Intra-Aortic Balloon Pumping Following Acute Myocardial Infarction
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37

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Goran, S.F., Vascular Complications of the Patient Undergoing Intra-Aortic Balloon Pumping, Critical
Care Nursing Clinics of North America, September 1989, 1(3): 459-467
Gottlieb, S.O.; Brinker, J.A.; Borken, A.M., et al, Identification of Patients at High Risk for Complications
of Intra-aortic Balloon Counterpulsation: A Multivariate Risk Factor Analysis, American Journal of
Cardiology 1984; 53:1135-1139
Kantrowitz, A.; Wasfie, T.; et al, Intra-aortic Balloon Pumping 1967 through 1982:
Complications in 733 Patients, American Journal of Cardiology 1986; 57:976-983

Analysis of

Kvilekval, Kara H.V., MD; et al, Complications of Percutaneous Intra-aortic Balloon Pump Use in Patients
With Peripheral Vascular Disease, Archives of Surgery, May 1991, Vol. 126, 621-623.
38

Lazar, H.L., MD; et al, Outcome and Complications of Prolonged Intraaortic Balloon Counterpulsation
in Cardiac Patients, American Journal of Cardiology April 1992, Vol 69 955-958
Schecter, D.; Murali, S.; Uretsky, B.F., Vascular Entrapment of Intra-aortic Balloon After Short Term
Balloon Counterpulsation, Catheterization and Cardiovascular Diagnosis 1991; 22:174-176
Stahl, K.D.; et al, Intra-aortic Balloon Rupture, Trans AM Soc Artif Intern Organs, 1988, Vol. XXXIV,
496-499
INSERTION
Gorton, M.E.; Soltanzadeh, H., Easy Removal of Surgically Placed Intra-aortic Balloon Pump Catheter,
Annals of Thoracic Surgery 1991; 51:325-6
Heebler, Robert F., Simplified Technique for Open Placement and Removal of Intra-aortic Balloon,
Annals of Thoracic Surgery 1989; 48:134-6
Nash, I.S., MD; et al, A New Technique for Sheathless Percutaneous Intra-aortic Balloon Catheter
Insertion, Archives of Surgery, May 1991, Vol. 126, 57-60
Phillips, Steven J., MD; et al, Sheathless Insertion of the Percutaneous Intra-aortic Balloon Pump: An
Alternate Method, Annals of Thoracic Surgery 1992; 53:162
Shahian, D.M.; Jewell, E.R., Intra-aortic Balloon Pump Placement through Dacron Aortofemoral Grafts,
Journal of Vascular Surgery 1988 June; 7:795-7
PEDIATRICS
Anella, J.; McCloskey, A.; Vieweg, C., Nursing Dynamics of Pediatric Intra-aortic Balloon Pumping,
Critical Care Nurse 1990 April; 10(4):24-28
del Nido, P.J.; et al, Successful Use of Intra-aortic Balloon Pumping in a 2-kilogram Infant, Annals of
Thoracic Surgery 1988 November; 46:574-576
Dunn, Jeffrey M., The Use of Intra-Aortic Balloon Pumping in Pediatric Patients, Cardiac Assists 1989
June; 5(1)
Nawa, Sugato MD; et al, Efficacy of Intra-aortic Balloon Pumping for Failing Fontan Circulation Chest
1988 March; 93/3: 599-603
Veasy, L.G.; Blalock, R.C.; Orth, J., Intra-aortic Balloon Pumping in Infants and Children, Circulation
1983; 68(5):1095-1100
Webster, H.; Veasy, L.G., Intra-aortic Balloon Pumping in Children, Heart and Lung 1985; 14(6)
TRANSPORT
Bellinger, R.L.; Califf, R.M.; Mark, D.B., Helicopter Transport of Patients During Acute Myocardial
Infarction, American Journal of Cardiology 1988 April; 61:718-722
39

Gottlieb, S.O.; Chew, P.H.; Chandra, N., Portable Intra-aortic Balloon Counterpulsation: Clinical
Experience and Guidelines for Use, Catheterization and Cardiovascular Diagnosis 1986; 12:18-22
Kramer, R.P., Jr., Helicopter-Transported Intra-Aortic Balloon Pumping: Advanced Technology Made
Airborne, Cardiac Assists 1988 June; 4(2)
Mertlich, G.; Quaal, S.J., Air Transport of the Patient Requiring Intra-Aortic Balloon Pumping, Critical
Care Nursing Clinics of North America, September 1989, 1(3); 443-458
NURSING CARE
Bavin, T.K.; Self, M.A., Weaning From Intra-Aortic Balloon Pump Support, American Journal of Nursing,
October 1991, 54-59
Patacky, M.G.; Garvin, B.J.; Schwirian, P.M., Intra-aortic Balloon Pumping and Stress in the Coronary
Care Unit, Heart and Lung 1985 March; 14(2)
Quaal, S.J., Guest Ed., Critical Care Clinics of North America, Philadelphia, W.B. Saunders December
1996; 8(4)
Shoulders, Odom, Managing the Challenge of IABP Therapy, Critical Care Nurse 1991 February;
11(2):60-76
Weinberg, L.A.; Buying Time with an Intra-Aortic Balloon Pump, Nursing 1988 September; 44-49

40

Clinical Support Services

Seminar for IABP
Subjective Evaluation
1
Poor
1. Please rate the overall quality of the program
2. Please rate how well this program met your
personal objectives
3. How well did this program meet the
following objectives?
a. Define the two (2) physiological effects
achieved by the mechanics of inflation and
deflation of the IAB as it relates to the cardiac
cycle illustrated by an augmented arterial
pressure waveform
b. Identify four (4) indications and three (3)
contraindications for IABP therapy.
c. Delineate the major clinical complications
associated with IABP therapy.
d. Discuss the operation and troubleshooting of
the Datascope IABP utilizing the Abbreviated
Operators Guide and Performance Checklist.
4. Please Rate the Following
Content
a. Theory of IABP
b. Technical recommendations for Datascope IABP
c.

Clinical considerations for an IABP patient

Speakers Presentation
a. Theory of IABP
b. Technical aspects of Datascope IABP
c.

Clinical considerations for an IABP patient

d. Teaching strategies and presentation style

5. Please rate how well the program will
change and/or validate your practice
6. Please rate the educational tools used
during the program
a. Teaching manual
b. Abbreviated Operators Guide
c.

Audiovisual Materials

7. Please rate the program facilities

41

2
Fair

3
Good

4
Very
Good

5
Excellent

Datascope Corp.
Cardiac Assist Division
15 Law Drive
Fairfield, NJ 07004
Tel. 1-973-244-6100

P/N 0002-08-0295
Datascope Corp. 1998