A long term intra-aortic balloon pump (LTIABP) includes an enlarged pumping chamber on the order of 50 cc to 65 cc, inclusive. The pumping chamber is an intra luminal, large volume, long term balloon pump. The balloon pump can include tapered longitudinal ends and/or be segmented into a plurality of pumping chamber segments, each pumping chamber subsegment separated by a flexible power conduit link, where the diameter of the pumping chamber subsegments are independent of one another such as decreasing in size as the subsegments are further from the heart to accommodate the decreasing diameter of the aorta. The LTIABP can be used with any skin connector, or can be used with a percutaneous access device (PAD). The PAD can be sized and shaped to be surgically implanted in any desired location of the patient corresponding to the particular entry selected for implantation of a temporary IABP or LTIABP.