Intra-aortic balloon pump in patients with ischaemic heart disease undergoing oesophagogastrectomy

Oesophagogastrectomy for carcinoma has a high operative mortality rate. Patients are elderly and ischaemic heart disease (IHD) is a recognised and frequent risk factor.

To illustrate the use of the intra-aortic balloon pump (IABP) as prophylaxis against cardiac complications in a group of such patients.

Five patients aged from 63 to 78 years were presented with operable adenocarcinoma of the oesophagus. They had IHD of a severity thought to pose a risk of myocardial infarction (MI) and/or failure at the time of oesophagogastrectomy. With the induction of anaesthesia, the IABP was inserted and left in situ for up to 24 hours.

There were no major adverse perioperative cardiac events. Four patients were discharged from hospital on the eighth and one on the tenth postoperative day.

The prophylactic use of IABP has a potential role in the prevention of cardiac complications in patients with IHD undergoing high risk non-cardiac surgery.