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Updated: Jun 24, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Prophylactic intra-aortic balloon pump in high-risk patients undergoing coronary artery bypass grafting: a propensity
Antonio Miceli1, Brenno Fiorani, Tommaso Hinna Danesi
1Department of Cardiac Surgery, St Andrea Hospital, University of Rome La Sapienza, Rome, Italy. antoniomiceli79@alice.it
Insights
Prophylactic use of the intra-aortic balloon pump (IABP) in high-risk patients undergoing coronary artery bypass grafting (CABG) may reduce low cardiac output syndrome (LCOS) and improve early outcomes. This intervention may also decrease postoperative myocardial infarction and shorten hospital stays.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Devices
Background:
- The prophylactic use of intra-aortic balloon pumps (IABP) to prevent postcardiotomy low cardiac output syndrome (LCOS) after coronary artery bypass grafting (CABG) remains debated.
- High-risk patients undergoing CABG are particularly vulnerable to postoperative complications such as LCOS.
Purpose of the Study:
- To evaluate the efficacy of prophylactic IABP in reducing postcardiotomy LCOS.
- To assess the impact of prophylactic IABP on early outcomes in hemodynamically stable, high-risk CABG patients.
Main Methods:
- A retrospective study of 141 high-risk patients undergoing CABG between May 2004 and August 2007.
- 38 patients received prophylactic IABP, while 103 did not.
- Propensity score adjustment was used to control for baseline differences between groups.
Main Results:
- Prophylactic IABP was associated with a significantly lower incidence of postcardiotomy LCOS (adjusted OR 0.07, P=0.006).
- Patients receiving prophylactic IABP also experienced fewer postoperative myocardial infarctions (adjusted OR 0.04, P=0.04).
- The length of hospital stay was shorter in the prophylactic IABP group (10.4 days vs. 12.2 days, P<0.0001).
Conclusions:
- Prophylactic IABP may improve the postoperative course for hemodynamically stable, high-risk CABG patients.
- The findings suggest that prophylactic IABP can reduce LCOS, postoperative myocardial infarction, and hospital stay.
Abstract:
The optimal use of prophylactic intra-aortic balloon pump (IABP) to prevent postcardiotomy low cardiac output syndrome (LCOS) is still debated and poorly defined. The aim of this study was to evaluate whether prophylactic IABP reduces the rate of postcardiotomy LCOS and improves the early outcome in hemodynamically stable, high-risk patients undergoing coronary artery bypass grafting (CABG). From May 2004 to August 2007, 141 consecutive risk patients underwent CABG. Of these 38 (27%) received prophylactic IABP. The remaining 103 patients underwent operation without preoperative insertion of the device. Prophylactic IABP patients were more likely to be younger (P<0.0001), had a recent myocardial infarction (P<0.0001), lower ejection fraction (P=0.006), and higher New York Heart Association (NYHA) functional class (P=0.05). After risk-adjusting for propensity score, prophylactic IABP patients had a lower incidence of postcardiotomy LCOS (adjusted OR 0.07, P=0.006), postoperative myocardial infarction (adjusted OR 0.04, P=0.04), a shorter length of hospital stay (10.4+/-0.8 vs. 12.2+/-0.6 days, P<0.0001) than those who did not receive IABP. This study shows that prophylactic IABP treatment for hemodynamically stable high-risk patients undergoing CABG may improve postoperative course reducing postcardiotomy LCOS, postoperative myocardial infarction and length of hospital stay.
