Intraaortic balloon pumping women: effects of balloon size on survival

Between 1972 and 1978, 429 patients underwent intraaortic balloon pump (IABP) counterpulsation in our institution. Ninety-six were women (22.4). The overall mortality was 52.9% for men and 69.8% for women. During 1978, however, the mortality for women decreased to 57.1%, even though they comprised a larger percentage of patients (28.2%) than before. The major indication for IABP support in these women was ischemic myocardial dysfunction resulting in failure to wean from cardiopulmonary bypass (THI hemodynamic Classification C) despite volume expansion and pharmacologic support. Improved results were obtained with the use of larger intraaortic balloons and direct ascending aortic IABP insertion (which allowed use of larger, more effective 30 or 40 ml balloons), combined with delayed sternal closure.