Counterpulsation: A concept with a remarkable past, an established present and a challenging future

Kapelios, Chris J.; Terrovitis, John; Siskas, Panagiotis; Kontogiannis, Christos; Repasos, Evangelos; Nanas, John N.

doi:10.1016/j.ijcard.2014.01.098

Cited by 20 publications

(13 citation statements)

References 70 publications

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“…The EuroSCORE of all 197 patients in this study was 6.48±3.16 (1–17), there were no statistical differences between the 0–120 and >120 min groups (P>0.05). This suggested that the operative risks of patients in both groups were similar.…”

Section: Resultsmentioning

confidence: 48%

“…Because IABP improved tissue perfusion to avoid progression of SIRS and MODS, patients had a chance to recover during the most dangerous part of the perioperative phase. The application of IABP in cardiac surgery has increased (17), and the rate of application of IABP in the cardiac surgery department of our hospital increased from 1.72% in 2011 to 4.78% in 2014.…”

Section: Discussionmentioning

confidence: 99%

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Clinical application of intra-aortic balloon pump in patients with cardiogenic shock during the perioperative period of cardiac surgery

Jiang

Zhu

et al. 2017

Experimental and Therapeutic Medicine

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Intra-aortic balloon pumps (IABP) have saved many patients with cardiogenic shock during the perioperative period of cardiac surgery. However, the ideal insertion timing is controversial. In the present study, we aimed to optimize the insertion timing, in order to increase the survival rate of the patients. A total of 197 patients with cardiogenic shock during the perioperative period of cardiac surgery and implemented IABP from January 2011 to October 2015 were selected for the study. Patients were divided into five groups on the basis of application timing of IABP: 0–60, 61–120, 121–180, 181–240 and >240 min. The 30-day mortality, application rate of continuous renal replacement therapy (CRRT), duration of mechanical ventilation, duration of hospital stay and hospitalization charges were analyzed in the above groups. The risk factors related to mortality and the occurrence of IABP complications were also analyzed. The mortality in the 0–60, 61–120, 121–180, 181–240 and >240 min groups were 42.17, 36.6, 77.3, 72.7 and 79.3%, respectively. Earlier IABP insertion resulted in less patients receiving CRRT from acute renal failure and less daily hospitalization charges. However, the IABP application timing had no effect on indexes such as hospitalization duration, duration of mechanical ventilation and total hospitalization charges. Multifactor logistic regression analysis indicated that the independent risk factors of death in patients with cardiogenic shock during cardiac surgery were related to IABP support timing and vasoactive-inotropic score (VIS) before balloon insertion. In the first 120 min of cardiogenic shock during the perioperative period of cardiac surgery, IABP application decreased 30-day mortality. Mortality was related with VIS score of patients, which can be used to predict the prognosis of patients with cardiogenic shock.

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Section: Resultsmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Clinical application of intra-aortic balloon pump in patients with cardiogenic shock during the perioperative period of cardiac surgery

Jiang

Zhu

et al. 2017

Experimental and Therapeutic Medicine

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“…Therapeutic usage of IABP is well known and accepted treatment strategy to reverse or prevent moderate LCOS owing to hibernating or stunned myocardium after acute coronary syndrome, during percutaneous cardiac interventions, along malign ventricular arrhythmias, and after mechanical complications of myocardial infarction [51]. High-risk patients undergoing cardiac operations may be also protected against adverse outcomes [52,53].…”

Section: Cardiomyopathies -Types and Treatments 422mentioning

confidence: 99%

“…However, when IABP support has only limited positive impact on cardiac hemodynamics, it cannot maintain adequate cardiac output in patients with decompensated severe left HF or reduce clinical symptoms and hemodynamic signs. In such cases, this hemodynamic supportive strategy must be complemented by more advanced MCS devices [50].Therapeutic usage of IABP is well known and accepted treatment strategy to reverse or prevent moderate LCOS owing to hibernating or stunned myocardium after acute coronary syndrome, during percutaneous cardiac interventions, along malign ventricular arrhythmias, and after mechanical complications of myocardial infarction [51]. High-risk patients undergoing cardiac operations may be also protected against adverse outcomes [52,53].…”

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confidence: 99%

Invasive Treatment in Advanced (Stage-D) Heart Failure

Kırali¹,

Yerlikhan²,

Hançer³

2017

Cardiomyopathies - Types and Treatments

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Heart failure is a complex, true pandemic clinical syndrome and is responsible for 5% of hospitalizations globally. Severe heart failure can manifest as two lethal clinical entities: (1) acute cardiac decompensation with cardiogenic shock after large acute myocardial infarction with mortality rates approaching 50% or after cardiac surgery with mortality rates higher than 65% and (2) chronic destructive cardiac remodeling or acute decompensative exacerbations of cardiomyopathies with one-year mortality of approximately 80% (worse than most types of cancer). Interventional therapies aim first to improve symptoms and life expectancy in patients with severe heart failure syndrome, second to prevent left ventricular remodeling, and third to bridge patients to long-term mechanical circulatory support or transplantation. Several treatment options can be used to stabilize patients. In particular, new percutaneous mitral valve interventions and short-term circulatory support devices open up a new temporary treatment area in symptomatic Stage-D heart failure. The durable or curable surgical destination treatment will be only permanent ventricular assist devices or heart transplantation. This chapter focuses on the treatment steps and new approaches in hospitalized Stage-D heart failure patients.Keywords: heart failure, heart transplantation, ventricular assist device, ECMO, ECLS At end-stage, any type of cardiomyopathy (CMP) causes a complex clinical heart failure (HF) syndrome, which results from structural and/or functional impairment of ventricular filling or ejection. This dire clinical situation can cause an adverse vicious cycle that is ultimately fatal if not treated by pharmacological or invasive mechanical support or heart transplantation (HTx). Left ventricular functional abnormalities range from normal-sized left ventricle (LV) with preserved left ventricular ejection fraction (LVEF) to severe left ventricular dilatation (LVD) with markedly reduced LVEF. Reduced LVEF is defined as the clinical diagnosis of HF and LVEF ≤40%, which means a clinic and functional association of systolic and/or diastolic LVD.© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Abnormal systolic and/or diastolic functions impair left ventricular contractile and relaxation functions that result in increasing left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV), as well as left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD), with the alteration of the left ventricular shape from conical form to spherical form. Adverse elevation of preload and afterload results in increasing left ventricular end-diastolic pressure (LVEDP) and left ventricular end-systolic pressure (LVESP). Inadequate unloading is the pr...

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“…A recent meta-analysis [ 1 ] reported that preoperative and 30-day mortality was significantly lower in patients who underwent coronary artery bypass graft (CABG) plus perioperative IABP. IABP is sometimes used in ventricular arrhythmia and high-risk percutaneous coronary intervention (PCI) [ 2 ]. Using IABP in thrombolytic therapy increases the survival rate of patients with acute myocardial infarction (AMI) and CS [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Temporal Trends of In-Hospital Mortality in Patients Treated with Intra-Aortic Balloon Pumping: A Nationwide Population Study in Taiwan, 1998-2008

Chen

Chu

et al. 2015

PLoS ONE

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Intra-aortic balloon pumping (IABP) is widely used for hemodynamic support in critical patients with cardiogenic shock (CS). We examined whether the in-hospital mortality of patients in Taiwan treated with IABP has recently declined. We used Taiwan’s National Health Insurance Research Database to retrospectively review the in-hospital all-cause mortality of 9952 (7146 men [71.8%]) 18-year-old and older patients treated with IABP between 1998 and 2008. The mortality rate was 13.84% (n = 1377). The urbanization levels of the hospitals, and the number of days in the intensive care unit, of hospitalization, and of IABP treatment, and prior percutaneous coronary intervention (PCI) were associated with mortality. Seven thousand six hundred thirty-five patients (76.72%) underwent coronary artery bypass grafting (CABG) surgery, and 576 (5.79%) underwent high-risk PCI with IABP treatment. The number of patients treated with IABP significantly increased during this decade (ptrend < 0.0001), the in-hospital all-cause mortality for patients treated with IABP significantly decreased (ptrend = 0.0243), but the in-hospital all-cause mortality of patients who underwent CABG and PCI plus IABP did not decrease. In conclusion, the in-hospital mortality rate of IABP treatment decreased annually in Taiwan during the study period. However, high-risk patients who underwent coronary revascularization with IABP had a higher and unstable in-hospital mortality rate.

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Counterpulsation: A concept with a remarkable past, an established present and a challenging future

Cited by 20 publications

References 70 publications

Clinical application of intra-aortic balloon pump in patients with cardiogenic shock during the perioperative period of cardiac surgery

Clinical application of intra-aortic balloon pump in patients with cardiogenic shock during the perioperative period of cardiac surgery

Invasive Treatment in Advanced (Stage-D) Heart Failure

Temporal Trends of In-Hospital Mortality in Patients Treated with Intra-Aortic Balloon Pumping: A Nationwide Population Study in Taiwan, 1998-2008

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