Evaluation of preoperative intra-aortic balloon pump in coronary patients with severe left ventricular dysfunction undergoing OPCAB surgery: early and mid-term outcomes.
BACKGROUND
The purpose of the present study was to evaluate the safety and the cost-effectiveness of using preoperative IABP as support compared with postoperative IABP treatment in coronary patients with severe left ventricular dysfunction (SLVD) who is undergoing off-pump coronary artery bypass surgery (OPCAB), including early outcomes, hospital mortality and morbidity, and mid-term follow-up outcomes.


METHODS
Between March 2000 and December 2008, we prospectively and randomly studied the insertion of preoperative IABP in 115 (7.4%) and postoperative IABP in 106 (6.8%) of the 1560 consecutive patients. Group A is preoperative IABP therapy. Group B is postoperative IABP therapy.


RESULTS
There was no significant difference in the number of grafts used between the two groups. Completeness of revascularization did not differ between the two groups. The statistically significant difference was hospital mortality (2.6% in group A vs. 3.8% in group B) (p < 0.05). And there was significant reduction in postoperative low cardiac output, malignant arrhythmia, acute renal failure and length of stay in ICU in group A, compared with group B (p < 0.05). In the two groups, six-, 12-, 24- and 48-month survival rates were similar. In the study the degree of improvement in angina and quality of life did not differ significantly between the two groups.


CONCLUSIONS
The use of preoperative IABP in SLVD patients undergoing OPCAB is of safety and effectiveness. The combined use of preoperative IABP and OPCAB allows complete revascularization in SLVD patients with an important reduction in operative mortality and excellent mid-term results.
Qiu
Zhibing
Z
Department of Thoracic and Cardiothoracic Surgery, Nanjing First Hospital affiliated to Nanjing Medical University, Nanjing Heart Institute, 210006 Nanjing, PR China. qiuzhibingjs@yahoo.com.cn
Chen
Xin
X
Xu
Ming
M
Jiang
Yingshuo
Y
Xiao
Liqiong
L
Liu
Lele
L
Wang
Liming
L
D058186:Acute Kidney Injury / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000601:surgery*