Effect and limitation of intra-aortic balloon pumping following valve replacement surgery

To evaluate the effect and the limitation of intra-aortic balloon pumping (IABP) in patients with severe left ventricular failure (LVF) following valve replacement surgery, we assessed the results of 282 patients who underwent such surgery. Among 25 patients in whom IABP was used after valve replacement, 17 patients could be weaned from IABP, and 14 of them achieved long-term survival. The durations of IABP support for patients who were weaned from IABP were shortened and were mostly within 48 hours, whereas those in patients not weaned from IABP tended to be prolonged. Among 25 IABP patients, 8 had definite causes of LVF such as perioperative myocardial infarction, but the other 17 patients experienced LVF despite uneventful operation. In the latter group of patients, preoperatively depressed left ventricular function was observed in 10 patients. In the former group of patients, the duration of IABP was much longer, and the weaning rate, as well as survival rate, was significantly poorer. On the other hand, in the latter-group patients, the duration of IABP was shortened and the survival rate was excellent. In conclusion, IABP support for patients with postoperative LVF of unknown causes, which might include patients with preoperatively depressed left ventricular function, was sufficiently effective, whereas no significant effect of IABP was noted for patients experiencing LVF after definite and serious perioperative complications.