Results and complications of intraaortic balloon counterpulsation

During the forty-month period ending July, 1976, intraaortic balloon counterpulsation was used as an adjunct to medical or surgical therapy in 273 patients. Thirty-seven developed complications. Limb ischemia occurred in 16; it resolved in 12, resulted in gangrene of the toes in 1 and leg gangrene in 2, and was the casue of death in 1 patient. Aortic dissection was confirmed in 7 patients and strongly suspected in another 4. Eight of the 11 patients with dissection underwent cardiac procedures with heparinization at two days to three months after balloon insertion with no untoward effects. Septicemia developed in 2 patients, 1 of whom died of cardiogenic shock. Localized groin sepsis occurred in 8 patients, 2 of whom required removal of infected Dacron graft material. Awareness of the complications of balloon insertion, proper attention to details of balloon management at the time of insertion and removal, and continuous monitoring through a central-lumen balloon should decrease the incidence of complications.