INTRA AORTIC BALLOON COUNTER PULSATION AN IMPROVED OUTCOME IN HIGH-RISK PATIENT FOR CORONARY ARTERY BYPASS SURGERY. “Intra-aortic Baloon Pump”

Intra aortic balloon pump (IABP) is the commonest used assisted device in cardiac surgery. Our aim is to investigate the effectiveness of therapy in our setup of patients, where poor ejection fraction, diffuse coronary artery disease and left main stem lesions are common. Retrospective study where 1296 patients underwent isolated CABG surgery for the period from Jan 1997 to Dec. 2003. 48 (3.7%) patients needed insertion of IABP perioperatively or early postoperatively. The early mortality rate in those who required IABP was 35% (17) of patients mean age of the patients was 56 ± 4 years, 36 (75%) patients have preoperative myocardial infarction (MI) within week before surgery, 39 (81%) patients were diabetic. Chronic renal failure was present in 4 (8%) patients, COPD was present in 2 (4%), poor left ventricular function (less than 30%) was present in 36 (75%) patients, 41 (85%) patients were male. 65% (31) of patients who developed sever myocardial depression at the conclusion of surgery survive and discharge home. Significant improve in hospital survival in those patients who otherwise died warn us liberal use of IABP. High risk patients with low cardiac out put after operation, patients with low ejection fraction, recent MI and peri or postoperative MI benefit most with IABP. Insertion of IABP is simple and easily available assisted devise.