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Updated: Sep 26, 2026

The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Preoperative intra-aortic balloon pump use and clinical outcomes in patients undergoing surgery for mitral
Abdul Rasheed Bahar1, Yasemin Bahar1, Mohamed Elhussain1
1Department of Medicine, Wayne State University School of Medicine Detroit, MI, USA.
Background:
Mitral regurgitation (MR) requiring surgical correction poses significant perioperative challenges, particularly in hemodynamically compromised patients. Evidence supporting preoperative intra-aortic balloon pump (IABP) use in this setting remains scarce. This study evaluated the association between preoperative IABP use and clinical outcomes in patients undergoing surgical MR correction.
Methods:
We conducted a retrospective cohort study utilizing the Nationwide Readmissions Database (NRD) from 2016 through 2020. Adult patients undergoing surgical mitral valve repair or replacement were identified using validated ICD-10-CM and ICD-10-PCS codes. Patients who received preoperative IABP were compared with those who did not through 1:1 propensity score matching, accounting for baseline clinical characteristics and illness severity. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE). Secondary outcomes included in-hospital mortality, perioperative complications, 30-day readmissions, and length of stay.
Results:
Among 33,644 hospitalizations for surgical MR correction, 1,691 (5.0%) involved preoperative IABP use. Following propensity score matching, 964 pairs were analyzed. Preoperative IABP use was associated with significantly lower rates of MACCE (16.8% vs. 19.6%, P = 0.045), in-hospital mortality (4.7% vs. 6.5%, P = 0.028), ischemic stroke (1.5% vs. 2.3%, P = 0.040), and prolonged mechanical ventilation (7.9% vs. 10.2%, P = 0.014). Thirty-day readmission rates and length of stay were also lower among IABP recipients.
Conclusions:
Preoperative IABP use was associated with modestly improved in-hospital outcomes and lower short-term readmissions, with the most pronounced benefits among high-acuity patients. These hypothesis-generating findings support a selective, severity-guided role for preoperative IABP, warranting prospective validation.
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