Related Experiment Videos
The intraaortic balloon pump for postcardiotomy heart failure. Experience with 169 intraaortic balloon pumps
J T Christenson1, L Buswell, V Velebit
1Cardiovascular Surgery Unit, Hôpital de la Tour, Switzerland.
Insights
Intraaortic balloon pump (IABP) use in cardiac surgery is common, especially for reoperations and emergency procedures. Femoral insertion is associated with complications like leg ischemia and groin infections.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Devices
Background:
- The intraaortic balloon pump (IABP) is a critical mechanical circulatory support device.
- It is frequently employed to manage perioperative heart failure in cardiac surgery patients.
Purpose of the Study:
- To review the clinical experience with 169 intraaortic balloon pump (IABP) insertions.
- To analyze IABP complications, insertion routes, and predictors of mortality.
Main Methods:
- Retrospective review of 169 IABP insertions between 1984 and 1993 in 3,591 adult cardiac surgery patients.
- Data collected on patient demographics, surgical procedures, IABP timing, insertion method, duration of support, and complications.
Main Results:
- IABP was used in 4.7% of cardiac surgery patients, more frequently in reoperations (14.8%) and emergency cases (50.7%).
- Femoral insertion (n=119) was more common than intraaortic (n=50).
- 8 complications (4.7%) occurred, all with femoral insertion, including leg ischemia (7 cases) and groin infection (1 case).
Conclusions:
- The intraaortic balloon pump (IABP) is a valuable tool in managing high-risk cardiac surgery patients.
- Femoral insertion, while common, carries risks of vascular complications.
- Careful patient selection and monitoring are essential for safe IABP utilization.
Abstract:
The intraaortic balloon pump (IABP) is usually the first mechanical device inserted for perioperative heart failure. In the present study we have reviewed our experience with 169 IABP insertions with emphasis on IABP complications, route of insertion, and identification of predictors of mortality. Between January 1, 1984 and March 31, 1993 3,591 adult patients underwent cardiac surgical procedures, 169 of whom (4.7%) had an IABP inserted preoperatively (7 patients, 4.1%), intraoperatively (109 patients, 64.5%), or postoperatively (53 patients, 31.4%). There were 137 men (81.1%) and the mean age was 60.2 +/- 8.8 years (28-78 years). Operations included 149 coronary bypass grafting (CABG) (4.6%, 149/3,209), 6 valve replacements, single or double (2.4%, 6/255), and 14 valves combined with CABG (11.0%, 14/127). The IABP was used more frequently in reoperations (14.8%, 80/542), compared to primary operations (2.9%, 89/3,049), p < 0.001. It was also more frequently used after emergency operations (50.7%, 39/77), than after elective operations (3.7%, 130/3,514), p < 0.001. In 119 patients femoral insertion was performed (13 percutaneously and 106 surgically), while 50 patients had an intraaortic insertion. The mean duration of IABP support was 50 hours (0.5-576 hours). There were 8 (4.7%) complications related to the balloon pump, all after femoral insertion (3 after transcutaneous and 5 after surgical insertions). Six of the complications occurred when the IABP was inserted intraoperatively and 2 postoperatively. The complications were 7 cases of leg ischemia (88%) and 1 groin wound infection.(ABSTRACT TRUNCATED AT 250 WORDS)