[Current use and outcomes of intraaortic balloon counterpulsation in routine cardiology]

Intraaortic balloon counterpulsation (IABC) is an established technique for temporary support of the left ventricular function. However, less is known about the current use and outcome of IABC in daily clinical practice.

From July 1995 to May 1999 all patients receiving an IABC in the Department of Cardiology of the Heart Center Ludwigshafen were included in a consecutive registry and follow-up data were obtained.

Sixty-six patients (mean age 65 years, 64% male) received an IABC during the registration period. In 95% of cases the indication for IABC was the presence of cardiogenic shock. The shock was due to an acute myocardial infarction in 83%, other reasons were less frequent (< or = 5%). Total inhospital mortality was 48%. Patients in shock due to myocardial infarction (53%) showed the highest mortality. During follow-up (median 20 months) another 21% died. Complications occurred in 20% of patients under IABC, including vascular complications in 12%, infections in 5% and major bleedings in 3%. There was no difference between mortality among patients with complications and total mortality.

Main indication for IABC in daily practice is the presence of cardiogenic shock (95%), dominantly due to myocardial infarction (83%). Despite IABC therapy, half of these patients die during the hospital stay. High mortality of cardiogenic shock in myocardial infarction with pharmacological therapy justifies IABC treatment with regard to a rate of complications of 20%.