Prophylactic Subclavian Artery Intraaortic Balloon Counter-Pulsation is Safe in High-Risk Cardiac Surgery Patients

The objective of this study was to determine the safety of prophylactic subclavian artery intraaortic balloon pumps (SCA-IABP) in high-risk cardiac surgery patients as a bridge to recovery (BTR). From November 2011 to January 2013, 11 consecutive patients at three institutions underwent prophylactic insertion of a SCA-IABP as a BTR. All patients (n = 11) had preoperative ejection fractions of 30% or less. Patients concurrently underwent one or a combination of the following procedures: coronary artery bypass grafting, mitral valve surgery, aortic valve replacement, left ventricular aneurysm resection, and ventricular/atrial septal defect closure. The primary outcome measure was a composite endpoint of device-related complications (including limb ischemia, stroke, device failure, bleeding requiring reoperation, brachial plexus injury, device-related infection, and vascular complications) and in-hospital mortality. Secondary outcome measures included interval to patient ambulation and postoperative length of stay. There were no device-related complications or in-hospital mortalities in this cohort of 11 consecutive patients. Mean time to ambulation, balloon pump support, and postoperative length of stay were 3.70 ± 2.50 days, 8.50 ± 7.00 days, and 15.9 ± 8.25 days, respectively. Prophylactic SCA-IABPs appear to be safe in high-risk cardiac surgery patients as a BTR.