Intra-aortic balloon counterpulsation support for elective coronary angioplasty in the setting of poor left ventricular function:  a two center experience.
A two-center elective coronary angioplasty experience with intra-aortic balloon pump support for patients with severe left ventricular dysfunction is reported.  To prevent hemodynamic collapse, an intra-aortic balloon pump was inserted percutaneously before coronary angioplasty in 97 patients with a left ventricular ejection fraction less than 35% (26% of whom had ejection fractions less than 25%).  The cohort was predominantly male (71%) with a mean age of 64 +/- 9 years.  Angioplasty was successfully performed in 83 (85.6%) patients and 80 (82.5%) of these successful patients were discharged from the hospital.  Seven patients had unsuccessful angioplasty without a major cardiac event.  Seven patients (7.2%) suffered a major cardiac event; 4 had emergent coronary bypass surgery with q-wave infarction, 2 had uneventful emergency coronary bypass surgery, and one patient died in the operating room after a failed angioplasty.  Using logistic regression analysis, the presence of multivessel disease and a history of prior myocardial infarction were associated with more complications during angioplasty (p less than 0.05). Intra-aortic balloon pump placement did not interfere with the angioplasty procedure.  Two patients had limb ischemia which resolved when the intra-aortic balloon pump was removed.  Of the 80 successful patients discharged, 72 were followed for a mean of 22 months.  At the latest follow-up, 52 had not suffered a myocardial infarction and were alive.  Of the 20 late deaths, 16 were cardiac and 4 non-cardiac.(ABSTRACT TRUNCATED AT 250 WORDS)
Anwar
A
A
San Francisco Heart Institute, Daly City, California.
Mooney
M R
MR
Stertzer
S H
SH
Mooney
J F
JF
Shaw
R E
RE
Madison
J D
JD
VanTassel
R A
RA
Murphy
M C
MC
Myler
R K
RK
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D015908:Counterpulsation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D016277:Ventricular Function, Left