Use of intra-aortic balloon pump in cardiac surgery: analysis of 80 consecutive cases

Abstract

Background:The low cardiac output syndrome in perioperative period of cardiac surgery may occur in about 10 to 15% of patients; of this total, 2% require mechanical support for adequate hemodynamic control.Objective: This study aimed to describe the mortality of patients requiring intra-aortic balloon pump (IABP) in transor post-cardiac surgery, identifying preoperative variables associated with a worse outcome, as well as describe the postoperative complications and survival in the medium term. Patients and Methods: retrospective cohort study including 80 consecutive cases between January/2009 and September/ 2011. The patients had on average 62.9 ± 11.3 years and 58.8% were male. In the sample, 81.3% were hypertensive, 50% had previous myocardial infarction and 38.8% heart failure NYHA III/IV. The most common surgery performed was isolated coronary artery bypass grafting (37.5%).Results: Hospital mortality was 53.8% (95% HF: 42.7-64.9) and the cross-clamp time >90 minutes was an independent predictor of mortality in multivariate analysis (RR 1.52 95% HF: 1.04-2.22). Regarding complications, 71.3% (95% HF: 61.2 to 81.4) of patients had at least one additional complication: the lower limb ischemia was observed in 5.0% of patients. The 1-year survival was 43.6%, observing a plateau in the survival rate after an initial sharp drop, related to hospital mortality.Conclusion: Patients who need the IABP form a group of very high risk for morbidity and mortality. Its use, however, allows many patients to recover an evolution that was invariably fatal, having the patients discharged home a good survival in the medium term.Descriptors: Intra-aortic balloon pumping. Cardiac surgical procedures. Cardiac output, low. ResumoFundamento: A síndrome de baixo débito cardíaco no perioperatório de cirurgia cardíaca pode incidir em cerca de 10 a 15% dos pacientes; desse total, 2% necessitam de suporte mecânico para adequado controle hemodinâmico.Objetivos: Descrever a mortalidade de pacientes que necessitaram utilizar balão intra-aórtico (BIAo) no trans ou pós-operatório de cirurgia cardíaca, identificando variáveis pré-operatórias associadas a pior desfecho, assim como descrever as complicações pós-operatórias e a sobrevida em médio prazo. Rev Bras Cir Cardiovasc 2012;27(2):251-9

The use of intra-aortic balloon pump in cardiac surgery

“…The frequency of use of intra-aortic balloon pump in the context of cardiac surgery varies in literature between cardiac surgical units between 2.1% in one study, and 22% in another study. 12,13 In our cardiac centre, the use of IABP has increased over the last decade. In our previous research from 2011, the rate of use of IABP was 6.46% of all adult cardiac surgical patients.…”