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Updated: Dec 19, 2025
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Prophylactic intra-aortic balloon pump in patients with left main disease undergoing off-pump coronary artery bypass
Ju-Bing Zheng1, Kun Hua1, Kui Zhang1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Street, Chaoyang District, Beijing, 100029, China.
Insights
Prophylactic intra-aortic balloon pump (IABP) use in stable left main disease patients undergoing off-pump coronary artery bypass grafting (OPCABG) showed no early benefit. This study suggests prophylactic IABP may be unnecessary for these patients.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Anesthesiology
Background:
- The use of prophylactic intra-aortic balloon pump (IABP) in high-risk patients with stable hemodynamics undergoing cardiac surgery remains controversial.
- The definition of
- high-risk
- in this context is not clearly established.
Purpose of the Study:
- To evaluate the impact of prophylactic IABP on early outcomes in patients with left main disease (LMD) undergoing off-pump coronary artery bypass grafting (OPCABG).
- To clarify the role of IABP in hemodynamically stable LMD patients undergoing OPCABG.
Main Methods:
- A study involving 257 consecutive patients undergoing OPCABG via sternotomy from January 2013 to April 2020.
- Comparison of early outcomes between 125 patients receiving prophylactic IABP and 132 control patients with stable hemodynamics (BP > 100 mmHg without vasopressors).
Main Results:
- Prophylactic IABP did not significantly improve outcomes regarding conversion to cardiopulmonary bypass (CPB), perioperative myocardial infarction (MI), or mortality.
- A higher incidence of prolonged ventilation was observed in the IABP group (RR 2.16, P=0.0221).
- No IABP-related mortality or limb ischemia was reported.
Conclusions:
- Prophylactic IABP demonstrated no significant difference in early outcomes for hemodynamically stable LMD patients undergoing OPCABG.
- The routine use of prophylactic IABP may not be necessary in this specific patient population.
Background:
Preventive intra-aortic balloon pump (IABP) for high-risk patients with stable hemodynamics is controversial, and its definition of high-risk is still unclear. This study aimed to investigate the effect of prophylactic IABP on the early outcome of left main disease (LMD) patients receiving off-pump coronary artery bypass grafting (OPCABG) with stable hemodynamics.
Methods:
From January 2013 to April 2020, 257 consecutive patients who underwent OPCABG through sternotomy were enrolled in this study. All LMD patients (greater than 70%) had stable hemodynamics (BP>100 mmHg without vasoconstrictor substance infusion). Early outcomes of 125 patients with prophylactic IABP (IABP group) and 132 patients without IABP (Control group) were compared in this study.
Results:
IABP did not show favorable effect on the conversion to CPB (RR 0.63, 95%CI 0.05-7.89, P = 0.7211), perioperative MI (RR 0.69, 95%CI 0.22-2.12, P = 0.5163), mortality (RR 0.65, 95%CI 0.04-10.25, P = 0.7608) or the composite end of the conversion, MI and mortality (RR 0.63, 95%CI 0.23-1.74, P = 0.3747). There was greater incidence of prolonged ventilation in IABP after adjustment (RR2.16, 95%CI 1.12-4.18, P = 0.0221). There was no IABP-related mortality or limb ischemia.
Conclusion:
No significant difference in early outcomes was observed in hemodynamically stable patients with LMD between prophylactic IABP group and control group. Prophylactic IABP may be unnecessary in patients with LMD undergoing OPCABG.
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