The effects of intraaortic balloon pumping (IABP) on portal venous flow were assessed using color Doppler echography. A total of 23 heart failure patients treated with IABP were assessed. Balloon inflation was timed to occur with every other cardiac contraction. The maximum, minimum, and mean flow velocity (Vmax, Vmin and Vmean, respectively) in the right portal vein were measured with the IABP ON and OFF, and the values compared. The Vmin with IABP ON and OFF was the same (11 +/- 5 cm/sec), whereas the difference between Vmax and Vmean was small for each patient. The velocities measured with IABP ON were larger than or equal to those with IABP OFF in all cases, however, except one. Thus, Vmax (22 +/- 8 cm/sec) and Vmean (17 +/- 6 cm/sec) with IABP ON were significantly larger (p 0.01) than those with IABP OFF (20 +/- 7 cm/sec and 16 +/- 6 cm/sec, respectively). The flow pattern of the portal vein was characteristically pulsatile either with IABP ON or OFF in most cases.