B-55 | Trends and Outcomes of Intra-Aortic Balloon Pump Use in Patients with Concomitant Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft: A 5-Year Cohort Study

Intra-aortic balloon pump (IABP) use in patients who had concomitant surgical aortic valve replacement (SAVR) and coronary artery bypass graft (CABG) has not been well studied. The National Inpatient Sample 2016-2020 was queried to identify adult patients who were hospitalized for concomitant SAVR with CABG surgery and were stratified based use of IABP. The primary outcome was the in-hospital mortality. Secondary outcomes included length of hospital stay, total charges, and in-hospital complications. Multivariate regression was used to adjust for baseline characteristics and comorbidities. Of 47,985 admissions of combined SAVR and CABG surgery, 3.5% required IABP use during that hospitalization. Patients who required IABP were more likely to be female (68% vs. 76%), White (83% vs. 87%), have a Charlson comorbidity index of > 3 (47% vs. 36%), and have Medicare (67% vs. 75%). Compared to patients who did not require IABP, those with IABP had a significantly higher risk of mortality (OR 9.46; p<0.001). They had a higher incidence of cardiogenic shock requiring pressors (OR 7.32; p<0.001), arrhythmias (OR 1.90; p<0.001), and cardiac arrest (OR 3.98; p<0.001). There were no differences in the risk of major bleeding (1.08; p=0.6) and stroke (OR 0.9; p=0.8). The length of hospital stay and hospital costs were higher in patients who required IABP (IRR 1.25 and IRR 1.54; both p<0.001). There was an increasing trend of IABP use in patients with concomitant SAVR and CABG (Ptrend<0.001). These findings reiterate the selective use of IABP in patients with more complex and severe clinical profiles. Further studies are needed to assess if IABP use reduces the risk of complications in this specific patient population.