Key result
Preoperative intraaortic balloon pump assistance in 90 high-risk patients resulted in 88% survival, whereas its use for cardiogenic shock in 60 patients resulted in 62% survival.
Why the study?
What are the indications and survival outcomes for intraaortic balloon pump assistance (IABP) in patients undergoing cardiopulmonary bypass?
Cohort (n=150)
What are the indications and survival outcomes for intraaortic balloon pump assistance (IABP) in patients undergoing cardiopulmonary bypass?
Preoperative IABP in high-risk patients undergoing cardiopulmonary bypass is associated with high survival rates and is indicated for severe pain relief, improving coronary perfusion, and protecting left ventricular function.
May support preoperative IABP consideration in high-risk bypass; case reports leave indications and shock outcomes open to randomized trials.
Over a two-year period about 1,000 operations were performed with cardiopulmonary bypass. Intraaortic balloon pump assistance (IABP) was employed on 150 occasions, and a review of these has permitted clarification of the indications for its use. Sixty patients had IABP for carcinogenic shock either after infarction or cardiotomy, and 37 (62%) survived. Preoperative IABP in 90 high-risk patients resulted in survival for 79 (88%). The indications for prophylactic IABP included: (1) relief of severe pain, which occurred in 42 patients with acute coronary insufficiency, (2) improvement in the coronary perfusion pressure, which was accomplished in 20 patients with significant left main coronary artery occlusion or its equivalent, and (3) protection of left ventricular function, which war carried out in 28 patients with an LV ejection fraction of less than 0.40. The significance of the preoperative endocardial viability ratio (EVR) in relation to prophylactic IABP was also assessed: an EVR below 0.70 appears to be an indication for preoperative IABP.
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Gunstensen et al. (1976) conducted a cohort in Cardiogenic shock or high-risk patients undergoing cardiopulmonary bypass (n=150). Intraaortic balloon pump assistance (IABP) was evaluated on Survival. Preoperative intraaortic balloon pump assistance in 90 high-risk patients resulted in 88% survival, whereas its use for cardiogenic shock in 60 patients resulted in 62% survival.
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