[Analysis of vascular complications of IABP therapy in open-heart surgery patients 1999-2004].
Intraaortic balloon pump (IABP) is being used in cardiac surgery in an increased ratio. IABP therapy involves considerable risk, mainly vascular complications, postoperative bleeding and infection can represent danger. Between 1999 and 2004 out of 4443 open heart surgery operations we have performed intraaortic balloon pump treatment in case of 75 patients. The mean age was 64 years, 23 patients had diabetes mellitus, 47 patients had hypertension, 20 patients had peripheral vascular disease as well. We performed IABP therapy most frequently during isolated coronary bypass operations (42 cases), but also combined operations (implantation of valve prosthesis + coronary bypass) represent a significant part (implantation of aortic valve prosthesis + CABG: 5 cases, implantation of mitral valve prosthesis + CABG: 8 cases). Vascular complications occurred in 10 cases--13.3%--out of 75 patients, including 7 fatal ones. Three cases are due to the IABP treatment itself: Crush syndrome was developed leading to the loss of the patient. Applying the multiple logistic regression model we have examined the effect of the following factors on the occurrence of vascular complications: gender, age, body surface, accompanying diseases (hypertension, diabetes, peripheral vascular disease), the method and timing of insertion. Peripheral vascular disease (p < 0.005) and hypertension (p = 0.01) represent independent risk factors regarding the occurrence of complications. Having performed chi-square test we have not identified significant correlations between mortality and vascular complications. In case of prevailing peripheral vascular disease, the application of alternative insertion techniques--via the ascending aorta, the axillary artery--are recommended.
Kovács
Endre
E
Semmelweis Egyetem Budapest, Er- és Szívsebeszeti Klinika, Budapest kovend@enternet.hu
Becker
Dávid
D
Daróczi
László
L
Gálfy
Ildikó
I
Hüttl
Tivadar
T
Laczkó
Agnes
A
Paukovits
Tamas
T
Vargha
Péter
P
Szabolcs
Zoltán
Z
D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000379:methods; D003444:Crush Syndrome / Q000209:etiology; D005121:Extremities / Q000098:blood supply; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology*