Abstract
4/2009
vol. 6
KARDIOCHIRURGIA DOROSŁYCH
Optimal time for intraaortic balloon pump application – a single-center experience
Kardiochirurgia i Torakochirurgia Polska 2009; 6 (4): 335–339
Online publish date: 2009/12/30
Introduce: Intraaortic baloon pump (IABP) is the most commonly used device for temporary support of the failing heart.
Aim: Assessment of IABP efficacy in the consecutive years and to evaluate if timing (pre-, intra- or postoperative) of IABP introduction had any impact on patient outcome.
Material and Methods: This study involved 170 patients (138 males and 32 females) at the mean age of 61.8 ±8.4 years who underwent cardiac surgical operations in the years 2000-2007 and had IABP introduced in the perioperative period. Patients were retrospectively divided into 3 subgroups: A (IABP introduced prior to surgery; n = 18), B (during surgery; n = 104) and C (after surgery; n = 48). Primary end-point of the study was 30-day mortality (a marker of IABP efficacy) calculated for either a whole group (additionally in years 2000-2003 and 2004-2007) or subsequent subgroups.
Results: In the postoperative period, 52 patients died (30.6%). IABP efficacy was significantly higher in the years 2004-2007 (75.5% survivals) than between 2000-2003 (60.3%) (p < 0.05). In the consecutive years, more frequently IABP was utilized prior to surgery (0% in 2002 and 24% in 2006). Early mortality was lower in subgroup A (16.7%; n = 3) than ether B (26.0%; n = 27) or C (45.8%; n = 22) (p < 0.05) although preoperative left ventricular ejection fraction was significantly (p < 0.05) impaired (25.2 ±5.0%) compared to group B (47.2 ±14.4%) and C (49.5 ±14.1%), respectively.
Conclusions: IABP is an efficient method of temporary support of the failing heart. The best results may be achieved if IABP is utilized before cardiac surgery.
Aim: Assessment of IABP efficacy in the consecutive years and to evaluate if timing (pre-, intra- or postoperative) of IABP introduction had any impact on patient outcome.
Material and Methods: This study involved 170 patients (138 males and 32 females) at the mean age of 61.8 ±8.4 years who underwent cardiac surgical operations in the years 2000-2007 and had IABP introduced in the perioperative period. Patients were retrospectively divided into 3 subgroups: A (IABP introduced prior to surgery; n = 18), B (during surgery; n = 104) and C (after surgery; n = 48). Primary end-point of the study was 30-day mortality (a marker of IABP efficacy) calculated for either a whole group (additionally in years 2000-2003 and 2004-2007) or subsequent subgroups.
Results: In the postoperative period, 52 patients died (30.6%). IABP efficacy was significantly higher in the years 2004-2007 (75.5% survivals) than between 2000-2003 (60.3%) (p < 0.05). In the consecutive years, more frequently IABP was utilized prior to surgery (0% in 2002 and 24% in 2006). Early mortality was lower in subgroup A (16.7%; n = 3) than ether B (26.0%; n = 27) or C (45.8%; n = 22) (p < 0.05) although preoperative left ventricular ejection fraction was significantly (p < 0.05) impaired (25.2 ±5.0%) compared to group B (47.2 ±14.4%) and C (49.5 ±14.1%), respectively.
Conclusions: IABP is an efficient method of temporary support of the failing heart. The best results may be achieved if IABP is utilized before cardiac surgery.
Keywords
heart failure, heart support, IABP
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