Experience with counterpulsation in cardiac surgical patients.

Abstract

At Sheffield Regional Cardiothoracic Unit, the AVCO intra-aortic balloon pump has been used on 25 occasions in 21 months. Of the 25 patients, 12 survived and left hospital. The procedure is particularly beneficial in patients who have suffered some failure of myocardial protection during operation and to those who are suffering from acute ischaemia or the sequelae of myocardial infarction. The place of preoperative counterpulsation is discussed. Patients with long-standing cardiac disease who have emergency surgery benefit less from counterpulsation. Those patients with chronic ischaemic damage to the heart have nothing to gain from the use of counterpulsation.

Intraaortic Balloon Counterpulsation: A Review

“…Using the IABP in patients with acute myocardial infarction with complications, such as cardiogenic shock, without any subsequent plan for surgery, has been shown to be less valuable. In a review of balloon pumping in 401 patients for cardiogenic shock who did not undergo surgery, the overall survival was 28% (113/401) with a range of 11 to 71%.4-14 In 24 recent studies in the literature, 1543 IABP patients treated both medically and surgically had an overall hospital survival of 50% (776/1543).4° 11-~3~ [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Most authors stressed the importance of early IABP in the treatment of cardiogenic shock and also pointed out better results in surgically managed cardiac patients, both pre-and postoperatively.…”