Effective surgical management of high-risk coronary patients using preoperative intra-aortic balloon counterpulsation therapy

High-risk coronary patients undergoing surgical myocardial revascularization (CABG). High-risk criteria required at least two of the following: redo CABG, unstable angina, left main stem stenosis >70%, preoperative left ventricular ejection fraction <0.30, and diffuse coronary artery disease.

Preoperative intra-aortic balloon counterpulsation therapy (IABP), optimally initiated 2 hours prior to aortic cross-clamping.

Standard care without preoperative IABP (implied from the randomized studies mentioned).

Preoperative cardiac index, postoperative mortality, morbidity, intensive care unit stay, total hospital stay, and procedural cost.hard clinical