Pre-operative intra-aortic balloon pump insertion in coronary artery bypass grafting patients reduces in-hospital morbidity 

Abstract

Background: The aim of this study was to determine if pre-operative intra-aortic balloon pump (IABP) insertion improves the surgical outcomes of coronary artery bypass grafting (CABG). Methods: Patients with EuroSCORE II > 1.2% who underwent CABG from 2009 to 2016 were included in the study. Patients who utilized intra-operative or post-operative IABP were excluded. The analysis included a total of 2907 patients, with 377 patients undergoing pre-operative IABP insertion and 1198 patients receiving no IABP support. Following propensity score matching, 250 patients from each group were eligible for further analysis. Results: 30-day mortality events occurred in 9 (3.6%) non-IABP users and in 12 (4.8%) IABP users (OR: 1.33 95%CI: 0.52–3.58). Kaplan-Meier survival curve analysis showed no significant differences between the two groups in mortality up to one year after the operation (p = 0.72). On multivariate analysis, IABP usage among the PSM patients was associated with lower 30-day mortality (OR: 0.28, 95%CI: 0.07–0.92, P-value = 0.043), 90-day mortality (OR: 0.26, 95%CI: 0.08–0.78, P-value = 0.022) and reduced risk of developing severe respiratory disorders (OR: 0.10, 95%CI:0.01–0.50, P-value = 0.011). Conclusion: Pre-operative IABP use in high-risk patients reduces 30- and 90-day mortality rates, along with a notable decrease in rates of severe respiratory disorders.