[The intraaortic balloon pumping--old problems and innovation].
Method of this treatment in Vilnius University Heart Surgery Clinic was started in 1976. The intraaortic balloon pumping in the urgent primary mechanical circulator support device for postcardiotomic heart failure. Method of this treatment was started in 1976. Demand of intraaortic balloon pumping was for 744 postcardiothomic patients (5.4%). The heart pathology that required postcardiotomic intraaortic balloon pumping were: heart valve replacement or repair - 385, coronary artery bypass grafting - 316, complex heart operations - 34, after heart transplant - 6, coronary artery bypass grafting plus left ventricle remodelation - 3. Four methods of intraaortic balloon insertion were used: incision of a. iliaca externa were performed for 332 patients, by means of transcutaneus a. femoralis punction - 248, by means of incision of ascending aorta - 154, and by means of incision of ascending aorta with tourniquets - 10.


RESULTS
One hundred seventy nine patients after valve replacement and repair operations were successfully disconnected from intraaortic balloon pumping and 157 (41%) discharged from the hospital. The best results were in aortic valve replacement patients and coronary artery bypass grafting patients 64-67% was disconnected from intraaortic balloon and 64-57% discharged from the hospital. Totally 411 (55%) postcardiotomic patients were successfully disconnected and 373 (50%) discharged from the hospital. Main complications of the treatment by intraaortic balloon pumping were: aortic balloon thrombosis - 34, rupture of balloon - 6, aortic dissection - 4, peripheral artery perforation and aneurysm - 3, bleeding from area of balloon insertion - 2. Intraaortic balloon pumping duration ranged from 3.5 to 141 hours.


CONCLUSIONS
Best results were in patients group with intraaortic balloon pumping who underwent coronary artery bypass grafting and aortic valve replacement. The insertion intraaortic balloon through ascending aorta with tourniquets is more physiological and it is no need of thoracotomy to extract the balloon.
Miniauskas
Saulius
S
Heart Surgery Center, Vilnius University, Santariskiu 2, 2021 Vilnius, Lithuania.
Uzdavinys
Giedrius
G
Semetiene
Giedre
G
D006348:Cardiac Surgical Procedures; D020878:Device Removal; D004630:Emergencies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data