Insertion of an intra-aortic counterpulsion balloon was necessary following 283 surgical procedures with the heart pump at Hospital Broussais. One instance of vascular trauma at the site of insertion of the balloon was reported in 36 cases (13 p. cent). This was treated according to the severity of the arterial lesion with the following techniques: closure with Goretex venous patch (n = 25), short ilio-femoral by-pass (n = 9) and extra-anatomical femoro-femoral by-pass (n = 2). The overall mortality of the patients who required an intra-aortic balloon was 19 p. cent, including one case of retrograde aortic dissection at the site of insertion of the balloon. The morbidity related to the insertion of the balloon was as follows: one leg amputation, two disabling intermittent claudication episodes.