title: Clinical experience with intraaortic balloon pump support in 728 patients.
abstract: From November, 1968, through December, 1976, intraaortic balloon pump (IABP) circulatory support was used 747 times in 728 patients. Overall in-hospital survival was 413/747 (56.9%). Survival with IABP since 1974 has been 65% (286/440) compared to 24% (18/75) in 1968-1971 (P < 0.001). Two practical changes have been associated with this improvement: 1) broadened indications for, and earlier insertion of, IABP; and 2) more aggressive surgical treatment of the primary cardiac lesion. Cardiogenic shock or chronic ischemic ventricular failure accounted for 78.7% (59/75) of IABP in 1968-1971; during 1974-1976 only 26.4% (116/440) of IABP-supported patients were in these categories (P < 0.001). Since 1974, 58.2% (153/263) of IABP patients had an operative procedure following IABP insertion compared to 37.7% (23/611 prior to 1971 (P < 0.01). The major complication rate has remained unchanged at 8.5%. IABP-related mortality rate was 0.8% (6/728). Earlier, more liberal, use of IABP hemodynamic support has led to increased survival in a large number of patients with complications of acute myocardial ischemia. The low mortality associated with its use vindicates earlier institution of IABP support in cardiogenic shock.
authors.affiliation: Department of Surgery, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: McEnany
authors.forename: H R
authors.initials: HR
authors.lastname: Kay
authors.forename: M J
authors.initials: MJ
authors.lastname: Buckley
authors.forename: W M
authors.initials: WM
authors.lastname: Daggett
authors.forename: A J
authors.initials: AJ
authors.lastname: Erdmann
authors.forename: E D
authors.initials: ED
authors.lastname: Mundth
authors.forename: R S
authors.initials: RS
authors.lastname: Rao
authors.forename: J
authors.initials: J
authors.lastname: DeToeuf
authors.forename: W G
authors.initials: WG
authors.lastname: Austen
mesh_terms: D004868:Equipment Failure; D005263:Femoral Artery; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007083:Iliac Artery; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology