Intra-aortic Balloon Counterpulsation in Cardiac Surgery Patients – Experiences of Department of Cardiac Surgery, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic

Česká verzia

Authors: V. Svitek; J. Manďák; J. Harrer
Authors place of work: Hradec Králové, prednosta: doc. MUDr. J. Harrer, CSc. ; Kardiochirurgická klinika Lékařské fakulty Univerzity Karlovy v Hradci Králové a Fakultní nemocnice
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 2, s. 68-73.
Category: Monothematic special - Original

Summary

Aim:
To evaluate the use of intra-aortic balloon pump (IABP) at the Department of Cardiac Surgery, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové and identifying the complications of this method and their frequency in long-term follow-up.

Method:
Retrospective analysis of the outcome of IABP use. From September 1994 to September 2007, 10,024 cardiosurgery operations were performed at the Department of Cardiac Surgery, University Hospital Hradec Králové, Czech Republic. IABP was applied in 363 cases (3.6%).Therapeutic indication for initiation of IABP at our department was the syndrome of low cardiac output in the postoperative period and during operation (difficulty in weaning from cardio-pulmonary bypass) and severe acute ischemic changes of myocardium refractory to pharmacotherapy. Prophylactic IABP was elective introduction of support before cardiac surgery in hemodynamically stable high risk patients.

Outcome:
From the group of 363 counterpulsated patients 192 were succesfully treated (52.9%), 171 patients (47.1%) died in consequence of cardiogenic shock and multiorgan failure. In 20 cases (5.5%) the IABP was introduced before the operation. Complications were observed in 61 patients (16.8%). Vascular complications were found in 27 cases (7.4%) including ischemic changes of the limb (14 cases – 3,9%), significant bleeding occurred at the site of puncture (7 cases – 1.9%), dissection of the femoral and iliac arteries (2 cases – 0.55%), perforation of the iliac artery (1 case – 0,3%). In 1 case (0.3%) the balloon was removed for intramural hematoma of the descending aorta without dissection. In 2 cases (0.55%) the balloon was led into the venous system. Thrombocytopenia occurred in our group in 23 patients (6.3%). Technical complications were observed in 7 cases (1.9%). None from our group of couterpulsated patinets had infectious complication.

Conclusion:
IABP is an effective and clinically verified mechanical cardiac support. Our results are similar to other studies.

Key words:
intra-aortic balloon counterpulsation – mechanical assist devices – cardiac surgery – syndrome of low cardiac output

Zdroje

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