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Preoperative intraaortic balloon pump before urgent coronary bypass grafting

Ingo Slottosch1, Oliver Liakopoulos2, Maximilian Scherner1

  • 11 Department of Cardiothoracic Surgery, University Hospital Magdeburg, Magdeburg, Germany.

Asian Cardiovascular & Thoracic Annals
|June 5, 2018
PubMed

Insights

Preoperative intraaortic balloon pump support in urgent coronary artery bypass grafting for acute coronary syndrome did not improve outcomes. This high-risk intervention showed no significant reduction in mortality or major adverse events after propensity-score matching.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Interventions

Background:

  • Urgent or emergency coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS) carries significant risks.
  • Intraaortic balloon pump (IABP) support is a potential intervention for high-risk cardiac surgery patients.

Purpose of the Study:

  • To evaluate the clinical impact of preoperative intraaortic balloon pump (IABP) support in patients undergoing urgent or emergency CABG for ACS.
  • To assess the effect of IABP on postoperative mortality and major adverse cardiovascular and cerebrovascular events (MACCE).

Main Methods:

  • Retrospective review of a single institutional database (April 2010 - December 2016).
  • Analysis of 1066 patients with ACS requiring urgent/emergency CABG.
  • Propensity-score matching was employed to compare outcomes between IABP and control groups.

Main Results:

  • Preoperative IABP use was associated with higher unadjusted mortality (20% vs. control).
  • After propensity-score matching, no significant differences were observed in all-cause mortality (20.0% vs. 18.2%), cardiac mortality (18.2% vs. 14.5%), or MACCE (29.1% vs. 27.3%).
  • Overall hospital mortality was 8.8% in the study cohort.

Conclusions:

  • Preoperative intraaortic balloon pump support does not provide additional clinical benefit for patients undergoing urgent or emergency CABG for acute coronary syndrome.
  • The findings suggest that preoperative IABP is not associated with improved outcomes in this specific high-risk patient population.

Keywords:
Coronary artery bypassHospital mortalityIntra-aortic balloon pumpingPostoperative complicationsTreatment outcome

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