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The Intra-Aortic Balloon Pump
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Is intra-aortic balloon pump absolutely contraindicated in type A aortic dissection?

N Jaussaud1, M Durand, A Boignard

  • 1Department of Cardiac Surgery, Timone University Hospital, Marseille, France - OChavanon@chu-grenoble.fr.

The Journal of Cardiovascular Surgery
|November 29, 2013
PubMed

Insights

Intra-aortic balloon pump (IABP) use in severe cardiogenic shock after type A aortic dissection surgery is a salvage option. While associated with high mortality, IABP did not cause aortic rupture or dissection extension in this patient group.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Intensive Care Medicine

Background:

  • Circulatory failure post-type A aortic dissection surgery carries high mortality.
  • Intra-aortic balloon pump (IABP) is typically contraindicated in aortic dissection.
  • Severe cardiogenic shock necessitates advanced circulatory support.

Purpose of the Study:

  • To evaluate the short and midterm outcomes of IABP use in patients with severe cardiogenic shock following type A aortic dissection surgery.
  • To assess the safety and efficacy of IABP as a salvage therapy in this high-risk population.

Main Methods:

  • A retrospective analysis of 10 patients who received postoperative IABP after type A aortic dissection repair between January 2000 and April 2008.
  • Details on IABP placement, duration, and complications were recorded.
  • Patient outcomes, including mortality, IABP weaning, dissection extension, and neurological sequelae, were analyzed.

Main Results:

  • Four of the 10 patients died, with no deaths directly attributed to IABP.
  • Eight patients were successfully weaned off IABP due to hemodynamic improvement.
  • No instances of IABP-related aortic rupture or dissection extension were observed; however, two patients had device-related complications and six required renal support.

Conclusions:

  • IABP can be considered a salvage option for severe cardiogenic shock post-type A aortic dissection surgery.
  • The study found no evidence of device-related aortic rupture or dissection extension.
  • High mortality and morbidity underscore the critical condition of these patients, emphasizing the need for careful consideration of IABP use.
Abstract

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