KARDIOCHIRURGIA DOROSŁYCH
Optimal time for intraaortic balloon pump application – a single-center experience

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.