Intra-aortic balloon counterpulsation in Denmark 1988–1991 Early results and complications

Ps, Olsen; Arendrup, Henrik; Jj, Thiis; Ke, Klaaborg; Ho, Holdgaard

doi:10.1016/1010-7940(93)90257-c

Cited by 10 publications

(6 citation statements)

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“…It reduces the energy requirement of the left ventricle and maximizes coronary perfusion by diastolic augmentation. 9 The most important indications for insertion of an IABP include intractable cardiac failure after CPB, preoperative stabilization of refractory angina, and severe LV dysfunction. Thus, at any time in the perioperative period, the use of intraaortic balloon counterpulsation may be required on the basis of these criteria.…”

Section: Discussionmentioning

confidence: 99%

Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy

Eid

1999

Asian Cardiovasc Thorac Ann

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Intraaortic balloon counterpulsation has become a prerequisite for surgical repair of a left ventricular aneurysm. From October 1991 to October 1996, 60 consecutive patients underwent left ventricular endoaneurysmorrhaphy. Most had associated procedures, mainly coronary artery bypass grafting. Twenty-two patients (36.7%) were in New York Heart Association functional class III or IV preoperatively. These included 16 (26.7%) who had low cardiac output requiring an intraaortic balloon pump in the perioperative period. Pharmacological inotropic support alone was inadequate in 13 of these patients, one required a balloon pump for 5 days preoperatively due to severe low cardiac output, and 2 needed mechanical support postoperatively for ventricular arrhythmia and low cardiac output. The other 44 patients (73.3%) recovered without mechanical support. This study highlights the important role of intraaortic balloon counterpulsation in the surgical treatment of postinfarction left ventricular aneurysm.

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Section: Discussionmentioning

confidence: 99%

Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy

Eid

1999

Asian Cardiovasc Thorac Ann

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“…The predominant complication is ischaemia in areas below the descending aorta as the balloon reduces blood flow and, thus, increases the risk of leg, visceral and renal ischaemia. [1][2][3] Most previous studies are retrospective and concern patients in whom the IABP is used for treatment of cardiac failure after weaning from cardiopulmonary bypass (CPB). The reported complication rate is high, ranging from 12% to 44%, with the majority of series reporting a frequency between 12% and 30%.…”

Section: Introductionmentioning

confidence: 99%

Intra-aortic balloon pumping increases renal blood flow in patients with low left ventricular ejection fraction

et al. 2008

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Intra-aortic balloon pumping (IABP) has, for decades, been one of the key treatment modalities following impaired cardiac function after cardiac surgery. IABP increases cardiac output, decreases oxygen consumption of the heart and relieves the left ventricle. However, a number of complications have been reported in connection with IABP treatment. Only a few studies have evaluated renal blood flow and the purpose of this prospective study was to evaluate whether renal blood flow was affected by IABP treatment in high-risk patients. After approval from the county ethical committee and informed consent, seven consecutive patients with low left ventricular ejection fraction and scheduled for preoperative IABP treatment were allocated to the study. Assessment of renal blood flow was based on ultrasound spectral Doppler estimation of the flow velocity profiles in the interlobar kidney arteries. The result was described as balloon index (BI), which is maximal systolic velocity divided by the temporal mean velocity. Typical velocity profiles were demonstrated in all patients before, during and after IABP. BI measurement changed with time (p <0.05). BI was lower during IABP compared to both pre-IABP and post-IABP (p <0.025), indicating a higher renal blood flow. No statistically significant changes were seen in s-creatinine or creatinine clearance. Assuming unchanged diameter of kidney arteries and no considerable decrease in renal resistance and/or compliance, we conclude that the interlobar renal blood flow was significantly increased during IABP treatment, measured by ultrasound Doppler technique, but without a simultaneously significant change in creatinine clearance.

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“…2,3,11,13,16 Despite this, the incidence of reported complications does not appear to have increased. 7,8,17,[19][20][21][22][23][24] The rate of complications reported in different series varies widely, from 8.7% to 42%, but when the main contemporary series in the literature are compiled, the incidences of complications and major complications are 15.5% and 10.5%, respectively, in a total of 3,258 procedures (Table V). In the present study, the overall complications rate was 10.4% (22 of nary artery bypass grafting and an IABP in a large prospective study.…”

Section: Discussionmentioning

confidence: 99%

In-Hospital Complications of Percutaneous Intraaortic Balloon Counterpulsation

Arceo¹,

Urban²,

Dorsaz³

et al. 2003

Angiology

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Complications related to intraaortic balloon counterpulsation pumping (IABP) remain a problem despite the development of small caliber balloon catheter shafts and introducer sheaths. The authors report their experience in counterpulsation-related complications of 201 consecutive patients who underwent 212 percutaneous counterpulsation balloon insertions from June 1989 to June 1996 by use of balloons with 8-9.5 French shafts. Of these, 82% were men and 36 (18%) were women, with a mean age of 61 +/-12 years. Indications for counterpulsation were acute myocardial infarction (AMI) (67%), severe left ventricular failure without AMI (20%), dilated cardiomyopathy (4%), unstable angina (3%), high-risk supported percutaneous coronary angioplasty (2%), and others (4%). IABP was instituted at the bedside in the intensive care unit in 82 patients (39%) and in the catheterization laboratory in 130 (61%). Median duration of counterpulsation was 48 hours (range 30 minutes to 25 days) with successful weaning from counterpulsation in 70% (148 of 212) of procedures. Overall in-hospital mortality rate was 45% (90 of 201). The overall complication rate was 22/212 (10.4%). Major complications were present in 10/212 procedures (4.7%): 6 patients with limb ischemia (1 death directly attributed to this complication, 1 with associated septicemia and limb amputation, 3 requiring surgical thromboembolectomy, and 1 with persistent limb ischemia treated medically until his death caused by intractable left ventricular failure), 2 with important bleeding (1 fatal despite vascular surgical repair and 1 requiring blood transfusion) and 2 with balloon rupture requiring vascular surgery. Minor complications were present in 12 procedures (5.7%), 6 with limb ischemia, 3 with local bleeding, and 3 with catheter dysfunction. All of these resolved after balloon removal and required no further intervention. When limb ischemia did develop it occurred after a median delay of 24 hours following balloon insertion (range 2 to 98 hours). The only predictor of limb ischemia among baseline clinical and procedure-related variables was an age greater than 60 years. Compared with previous recent studies, the rate of complications observed in this study performed with small balloon catheters was acceptably low. Limb ischemia was the most frequent complication, often occurred early, and required further intervention in half the cases.

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Intra-aortic balloon counterpulsation in Denmark 1988–1991 Early results and complications

Cited by 10 publications

References 0 publications

Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy

Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy

Intra-aortic balloon pumping increases renal blood flow in patients with low left ventricular ejection fraction

In-Hospital Complications of Percutaneous Intraaortic Balloon Counterpulsation

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