Evaluation of preoperative intra-aortic balloon pump support in high risk coronary patients

Christenson, Jan T.; Simonet, F; Badel, Pierre; Schmuziger, M

doi:10.1016/s1010-7940(97)00087-0

Cited by 125 publications

(73 citation statements)

References 12 publications

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“…The identification of risk factors associated with the development of LCOS in coronary artery bypass surgery is essential to optimize pre-operative risk factors involved in strategies to improve myocardial protection and early intraoperative hemodynamic support [3], and set high-risk groups hemodynamically stable that may benefit from prophylactic use of intra-aortic balloon [6,7].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery

Sá¹,

Nogueira²,

Ferraz³

et al. 2012

Rev Bras Cir Cardiovasc

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Fatores de risco para síndrome de baixo débito cardíaco após cirurgia de revascularização miocárdicaRisk factors for low cardiac output syndrome after coronary artery bypass grafting surgery Abstract Objectives: Low cardiac output syndrome (LCOS) is a serious complication after cardiac surgery and is associated with significant morbidity and mortality. The aim of this study is to identify risk factors for LCOS in patients undergoing coronary artery bypass grafting (CABG) in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco -PROCAPE (Recife, PE, Brazil).Methods: A historical prospective study comprising 605 consecutive patients operated between May 2007 and December 2010. We evaluated 12 preoperative and 7 intraoperative variables. We applied univariate and multivariate logistic regression analysis.Results: The incidence of LCOS was 14.7% (n = 89), with a lethality rate of 52.8% (n = 47). In multivariate analysis by logistic regression, four variables remained as independent risk factors: age ≥ 60 years (OR 2.00, 95% CI 1.20 to 6.14, P = 0.009), on-pump CABG (OR 2.16, 95% CI 1.40 to 7.08, P = 0.006), emergency surgery (OR 4.71, 95% CI 1.34 to 26.55, P = 0.028), incomplete revascularization (OR 2.62, 95% CI 1.32 to 5.86, P = 0.003), and ejection fraction <50%.Conclusions: This study identified the following independent risk factors for LCOS after CABG: age ≥ 60 years of off-pump CABG, emergency surgery, incomplete CABG and ejection fraction <50%. Rev Bras Cir Cardiovasc 2012;27(2):217-23

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Section: Introductionmentioning

confidence: 99%

Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery

Sá¹,

Nogueira²,

Ferraz³

et al. 2012

Rev Bras Cir Cardiovasc

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“…Some studies suggest that using preoperatively IAP has significant impact when LVEF is less than or equal to 40% [1] [9], while others indicate when it is less than 30% [10]. For this study, were included patients with LVEF less than or equal to 40% (31.25% ± 8.53%).…”

Section: Discussionmentioning

confidence: 99%

“…While some groups do on the day before the surgery, others choose to install it right after anesthesia [1] [12]- [14]. In this study, the authors chosen to install the IABP on the day before the surgery and, in cases of LVEF lass than 30%, it was associated dobutamine at doses of 5 -7.5 micrograms per kilogram per minute, aiming the full inotropic prepare to the surgery time.…”

Section: Discussionmentioning

confidence: 99%

“…Changes in segmental contractility often present in patients with coronary artery disease are encompassed in the calculations, making the LVEF estimated value more accurate. [12] Christenson JT et al demonstrated that patients treated with IABP in the preoperative had CPB duration lower than patients who did not [1]. Furthermore, Kern F et al observed that CPB time lower than or equal to 90 minutes is significantly associated with a higher incidence of postoperative myocardial infarction [9].…”

Section: Discussionmentioning

confidence: 99%

“…The intra-aortic balloon (IAB) inserted through the femoral artery was at first described in 1962, as a circulatory support [1]. Due to the mechanical assistance, the IABP produces counter pulsation inside the descending aorta, determining an increase on coronaries arteries infusion during the diastole and cardiac work optimization due to the systole after load reduction.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

Freitas¹,

Gurian²,

Saporito³

et al. 2016

WJCD

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Background: The intra-aortic balloon pumping (IABP) is the most used ventricular mechanical assist device. In recent years, the preoperative use in patients with severe ventricular dysfunction presents itself as a great benefic strategy to the postoperative recovery. This paper aim is to evaluate the IABP post-operative benefit in patients with severe ventricular dysfunction. Methods: From January 2011 to March 2016, 125 patients underwent a coronary artery bypass graft (CABG) with cardiopulmonary bypass and preoperative IABP in Teaching Hospital of the ABC Medical School and Hospital Estadual Mario Covas. The inclusion criteria were the presence of severe ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) less than or equal to 40%, estimated by Doppler echocardiography using the Simpson method. The preoperative LVEF was 30.25% ± 8.53% and the diastolic diameter of the left ventricle (LVDD) 67.75 ± 16.37 mm. IABP was installed approximately 15 hours before the surgery. Results: The patients required the IABP for 2.4 ± 1.58 days, and vasoactive drugs, 4.8 ± 2.12 days. We performed 3.2 ± 1.9 grafts per patient and the total length of stay was 07 ± 5.52 days. Cardiopulmonary bypass time was 67 ± 10.95 minutes and anoxia time, 46.4 ± 10.06 minutes. Twelve patients (9.6%) had pneumonia and four (3.2%), atrial fibrillation. We observed a LVDD reduction to 63 ± 16.26 (p = 0.068) and LVEF enhancement to 36.50 ± 16.86 (p = 0.144). The data were analyzed statistically according to the Wilcoxon test. There were no deaths. Conclusion: The initial experience of the authors with the preoperative IABP in patients with severe left ventricular dysfunction suggests great benefit in post-operative recovery with improvement of LVEF and reduction of LVDD.

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Intraaortic Balloon Pump

Weller

Morrow

2006

Encyclopedia of Medical Devices and Instrumentation

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The intra‐aortic balloon pump (IABP) is an implanted cardiac assist device that utilises the principle of counterpulsation to provide temporary assistance to the failing heart. The balloon inflates during diastole (relaxation) and deflates before systole (contraction). This has two primary effects. First, it causes a decrease in the peak aortic blood pressure during systole, called systolic unloading. Second, it causes an increase in the mean aortic blood pressure during diastole, called diastolic augmentation. Systolic unloading decreases the oxygen demand of the heart and is enhanced by earlier balloon deflation. Diastolic augmentation increases the oxygen supply to the heart and is enhanced by later balloon deflation. The IABP therefore improves the myocardial oxygen balance and this can help the failing heart to recover. Furthermore, fine adjustment of the balloon deflation time can maximize this improvement. This article introduces the medical theory and need for intra‐aortic balloon pumping. A brief historical background is then presented. The techniques and principles of counterpulsation are then described. The article concludes with an examination of current developments and problems in this arena.

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Evaluation of preoperative intra-aortic balloon pump support in high risk coronary patients

Cited by 125 publications

References 12 publications

Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery

Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

Intraaortic Balloon Pump

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