Early vascular complications of intraaortic balloon counterpulsation in patients undergoing open heart surgery.
OBJECTIVE
The use of IABP is helpful for haemodynamic stability of patients with low cardiac output and compromised left ventricular function in patients who undergo coronary artery bypass grafting. This procedure is also associated with some vascular complications due to the insertion of IABP. The objective of this research was to study the vascular complications in patients with IABP counterpulsation. We observed the clinical outcome of these patients with special reference to post IABP complications in our research.


METHODS
One hundred and six consecutive patients were included in this study from August 2005 to February 2007. Mean age of patients was 58.08 +/- 1.814 years. Seventy nine patients (74.5%) were male and 29 (25.5%) were females. Out of these 106 patients, 101 were operated for CABG, one for angina due to aortic stenosis, two patients had ischemic mitral regurgitation and one patient had post infarct VSD. In 102 (96.2%) patients IABP was inserted percutaneously, one patient received transthoracic and in three patients IABP was inserted with open technique. Thirteen (12.3%) patients received IABP with sheath and 93 (87.7%) received IABP without sheath.


RESULTS
Ten patients (9.4%) out of 106 developed vascular complications due to insertion of IABP. Seven patients (6.6%) had the major complications and 3 (2.8%) patients developed minor vascular complications. Mortality due to vascular complications in 106 patients was 8.49% with p < 0.005.


CONCLUSIONS
IABP has remarkable beneficial effects in patients with haemodynamic instability due to myocardial ischemia and low cardiac output syndrome. At the same time IABP is related to significant morbidity and mortality related to vascular complications due to its insertion which include limb ischemia, limb loss and even mortality.
Riaz
Waseem
W
Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan.
Shahbaz
Ahmad
A
Sami
Waqas
W
Khan
Jawad Sajid
JS
D000368:Aged; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery; D002303:Cardiac Output, Low / Q000209:etiology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005121:Extremities / Q000098:blood supply; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects* / Q000379:methods*; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D017202:Myocardial Ischemia / Q000209:etiology / Q000601:surgery*; D010154:Pakistan; D011446:Prospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications