Preoperative Use of Intra-Aortic Balloon Pump Support Reduced 30-Day Mortality in a Population with LVEF >35% and High Surgical Risk after Coronary Artery Bypass Graft Surgery

Abstract

Introduction: The intra-aortic balloon pump (IABP) is used to prevent complications after coronary artery bypass grafting (CABG) surgery, although some results are controversial and basal ventricular function may play a role. This study assessed the benefit of preoperative use of IABP, as stratified by the ventricular function, in a population submitted to high-surgical-risk CABG. Methods: Patients > 18 years old, with multiple coronary artery disease and thus candidates for CABG, were included. Cardiogenic shock, acute myocardial infarction (AMI), acute ventricle mechanical dysfunction, severe aortic regurgitation, tachyarrhythmia, massive pulmonary embolism, coagulopathy, or low life expectancy Escutia-Cuevas et al.

Use of intra‐aortic balloon pump during coronary artery bypass graft surgery. Current questions and few answers

“…On the other hand, the multivariable logistic regression analysis shown that the risk factors for in‐hospital mortality were preoperative plasma creatinine and CABG time, OR = 5.74 and OR = 1.02, respectively ( p < .05). All these data are consistent with another previous studies 11–13 thus deserving special attention.…”

“…Regarding secondary endpoints, the study of Samadi et al shows that patients with left ventricular ejection fraction (LVEF) ≤ 35% had longer in‐hospital length of stay compared to patients with LVEF > 50% (median [interquartile range]: 10 [8–13] and 8 [7–10] days, respectively [ p = .04]), already seen in previous reports 9,11,13,18 . This outcome may be explained by the time required for accomplishing the IABP weaning as well as the time for recovery after the operation, a feature observed in almost all similar studies, thus giving an external validation to the results obtained in the study.…”

Use of Intra-Aortic Balloon Pump During Coronary Artery Bypass Graft Surgery. Current Questions and Few Answers.

“…On the other hand, the multivariable logistic regression analysis shown that the risk factors for in-hospital mortality were preoperative plasma creatinine and CABG time, OR=5.74 and OR=1.02, respectively (p<0.05). All this data consistent with another previous studies (11,12,14) thus deserving special attention.…”

“…Regarding secondary endpoints, the study of Samadi et al shows that patients with LVEF [? ]35% had longer in-hospital length of stay (LOS) compared to patients with LVEF >50% (median [IQR] 10 [8-13] days and 8 [7][8][9][10] days respectively [p=0.04]), already seen in previous reports (9,11,14,18). This outcome may be explained by the time required for accomplish the IABP weaning as well as the time for recovery after operation, a feature observed in almost all similar studies, thus giving an external validation to the results obtained in the study.…”

Mechanical Support in Early Cardiogenic Shock: What Is the Role of Intra-aortic Balloon Counterpulsation?

“…Although some meta-analyses suggest a benefit in mortality and MACCE, the prophylactic pre-operative insertion of IABP in patients undergoing high-risk coronary artery bypass grafting (CABG) remains controversial [18][19][20][21].…”