title: Long intraaortic balloon treatment time leads to more vascular complications.
abstract: Intraaortic balloon counterpulsation is an established and efficient therapy. Limb ischemia is the most common complication. The impact of treatment duration on balloon-related complications was analyzed retrospectively in 135 patients who underwent balloon counterpulsation between 1998 and 2004. Thirty high-risk coronary patients required preoperative intraaortic balloon therapy, 41 were in preoperative cardiogenic shock, and 64 needed support for difficulties in weaning from cardiopulmonary bypass. No balloon-related mortality occurred. The overall balloon-related complication rate was 20/135 (14.8%); 18 had limb ischemia, of whom 6 (4.4%) required vascular interventions. Intraaortic balloon treatment time was significantly longer in patients who developed limb ischemia (99.8 +/- 54.1 h) compared to those who did not (34.4 +/- 30.4 h). Preoperative therapy had short treatment times and few complications. Intraaortic balloon pumping provides effective circulatory support with a low complication rate. A clear relationship was established between duration of treatment and balloon-related complications. Independent risk factors for balloon-related complications were long treatment time, acute myocardial infarction, age over 65 years, and ejection fraction less than 0.30.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital of Geneva, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland. jan.christenson@hcuge.ch
authors.forename: Jan T
authors.initials: JT
authors.lastname: Christenson
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.forename: Jacques-André
authors.initials: JA
authors.lastname: Romand
authors.forename: Marc
authors.initials: M
authors.lastname: Licker
authors.forename: Afksendyios
authors.initials: A
authors.lastname: Kalangos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005121:Extremities / Q000098:blood supply*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D007511:Ischemia / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D016017:Odds Ratio; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications