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Updated: Dec 11, 2025
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Intraoperative intra-aortic balloon pump improves 30-day outcomes of patients undergoing extensive coronary
Zhen Wu1, Changcheng Liu1, Ying Fang1
1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Anzhen Street No.2 Chaoyang District, Beijing, 100029, China.
Insights
Intraoperative intra-aortic balloon pump (IABP) support may improve 30-day outcomes for high-risk patients undergoing off-pump coronary artery bypass grafting with coronary endarterectomy. Postoperative IABP was associated with increased risk of acute myocardial infarction and mortality.
Area of Science:
- Cardiovascular Surgery
- Cardiology
- Medical Devices
Background:
- Intra-aortic balloon pump (IABP) efficacy is established in high-risk coronary artery bypass grafting (CABG) patients.
- Limited data exist on IABP timing and benefits in patients undergoing CABG combined with coronary endarterectomy (CE).
Purpose of the Study:
- To assess the impact of intraoperative versus postoperative IABP on 30-day outcomes in patients undergoing off-pump CABG with CE.
- To identify risk factors for adverse 30-day outcomes in this patient population.
Main Methods:
- Retrospective study of 546 patients undergoing off-pump CABG+CE from January 2012 to December 2018.
- Patients were divided into a control group (n=437) and an IABP group (n=109).
- Subgroup analysis examined the effect of IABP timing on 30-day outcomes.
Main Results:
- Coronary endarterectomy (CE) on the left anterior descending artery (LAD), CE involving ≥2 vessels, and plaque length ≥3 cm were independent risk factors for postoperative acute myocardial infarction (AMI) and 30-day mortality.
- Postoperative IABP support was significantly associated with increased risk of AMI and 30-day mortality compared to intraoperative IABP (OR=3.987, P=0.025).
Conclusions:
- Intraoperative IABP support may be beneficial for patients undergoing off-pump CABG with extensive CE (LAD, ≥2 vessels, plaque ≥3 cm).
- Postoperative IABP is associated with poorer 30-day outcomes in this cohort.
Background:
The efficacy of intra-aortic balloon pump (IABP) has been proven in high-risk patients undergoing coronary artery bypass grafting (CABG). However, data on the timing and benefits of IABP support in diffuse coronary artery disease after CABG combined with coronary endarterectomy (CE) remain scarce. This retrospective study assessed the effect of intraoperative or postoperative IABP on 30-day outcomes of off-pump CABG+CE.
Methods:
From January 2012 to December 2018, 546 patients undergone off-pump CABG+CE were divided into control group (n = 437) and IABP group (n = 109). Risk factors for 30-day outcomes were evaluated. Subgroup analysis from IABP group was conducted to identify the effect of timing IABP on 30-day outcomes.
Results:
CE on left anterior descending branch of coronary artery (LAD) (OR = 3.079, 95% CI 1.077-8.805, P = 0.036), CE with≥2 vessels (OR = 9.123, 95% CI 3.179-26.033, P < 0.001) and length of atherosclerotic plaque ≥3 cm (OR = 16.017, 95% CI 5.941-43.183, P < 0.001) were independent risk factors for postoperative acute myocardial infarction (AMI) and 30-day mortality. Comparing with intraoperative IABP support, postoperative IABP support (OR = 3.987, 95% CI1.194-13.317, P = 0.025) was closely associated with postoperative AMI and 30-day mortality.
Conclusions:
For patients undergone off-pump CABG and extensive CE (CE on LAD, CE ≥2 vessels and length of atherosclerotic plaque ≥3 cm), intraoperative IABP support may improve 30-day outcomes.
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