Complications related to intra-aortic balloon pump in cardiac surgery: a decade later.
BACKGROUND
Our centre in 1995 reported 26% of vascular complications in cardiac surgical patients treated with intra-aortic balloon pump (IABP). However, during the last decade there have been improvements in IABP technology and insertion techniques. We aimed to evaluate the impact of these changes on the incidence of IABP-related complications in cardiac surgery.


METHODS
Demographics, indications, technique and complication rate in 186 consecutive patients treated with IABP from January 1994 to December 1998 (Group I) were compared with 323 consecutive patients treated with IABP from January 1999 to December 2003 (Group II) at our regional cardiothoracic centre. Data was variably expressed as mean with or without range and either standard deviation or range. Statistical significance was accepted at P<0.05.


RESULTS
There were 121 (65%) and 194 (60%) males in Group I and II, respectively. The mean age was 66+/-12.1 (17-88) years and the mean duration of IAPB use was 43.5h (range 3-144 h). Overall complication rate was 10% in Group I and 2% in Group II whereas vascular complications accounted for 3% in Group-I and 1% in Group-II. Logistic regression analysis demonstrated cardiogenic shock being strongly correlated to in-hospital mortality (OR 4.68; P=0.004) followed by older age (OR 3.12; P=0.034) and ejection fraction <35% (OR 1.78; P=0.03).


CONCLUSIONS
The study demonstrated a significant decrease in the IABP-related complications even though complexity of cases referred for surgery has increased. Henceforth, the risk of 1% vascular complications should play little influence on decision-making regarding the use of IABP.
Elahi
M M
MM
Department of Cardiothoracic Surgery, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Maqsood@doctors.org.uk
Chetty
G K
GK
Kirke
R
R
Azeem
T
T
Hartshorne
R
R
Spyt
T J
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000293:injuries*; D006348:Cardiac Surgical Procedures / Q000295:instrumentation* / Q000639:trends; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects* / Q000295:instrumentation; D007431:Intraoperative Complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000401:mortality; D016019:Survival Analysis; D014652:Vascular Diseases / Q000401:mortality*