The Role of Intra-Aortic Counterpulsation in High-Risk OPCAB Surgery:

30 adult high-risk coronary patients undergoing off-pump coronary artery bypass (OPCAB) surgery. High risk defined as having at least 2 of: EF < 0.30, left main stenosis, unstable angina, or redo operation. Cohort included 33% emergency operations, 13% re-operations, 100% unstable angina, 60% left main stenosis, and mean EF 0.29.

Intra-aortic balloon counterpulsation (IABC) started prior to induction of anesthesia

No preoperative IABC (bailout cardiopulmonary bypass or IABC allowed for hemodynamic instability)

Cardiac protection (troponin 1, cardiac index, ECG), inflammatory response (lactate, IL-6), and clinical outcome (mortality, morbidity)