The need for intra aortic balloon pump support following open heart surgery: risk analysis and outcome.
BACKGROUND
The early and intermediate outcome of patients requiring intraaortic balloon pump (IABP) was studied in a cohort of 2697 adult cardiac surgical patients.


METHODS
136 patients requiring IABP (5.04%) support analysed over a 4 year period. Prospective data collection, obtained.


RESULTS
The overall operative mortality was 35.3%. The "operation specific" mortality was higher on the Valve population.The mortality (%) as per time of balloon insertion was: Preoperative 18.2, Intraoperative 33.3, postoperative 58.3 (p < 0.05).The incremental risk factors for death were: Female gender (Odds Ratio (OR) = 3.87 with Confidence Intervals (CI) = 1.3-11.6), Smoking (OR = 4.88, CI = 1.23- 19.37), Preoperative Creatinine>120 (OR = 3.3, CI = 1.14-9.7), Cross Clamp time>80 min (OR = 4.16, CI = 1.73-9.98) and IABP insertion postoperatively (OR = 19.19, CI = 3.16-116.47).The incremental risk factors for the development of complications were: Poor EF (OR = 3.16, CI = 0.87-11.52), Euroscore >7 (OR = 2.99, CI = 1.14-7.88), history of PVD (OR = 4.99, CI = 1.32-18.86).The 5 years survival was 79.2% for the CABG population and 71.5% for the valve group. (Hazard ratio = 1.78, CI = 0.92-3.46).


CONCLUSIONS
IABP represents a safe option of supporting the failing heart. The need for IABP especially in a high risk Valve population is associated with early unfavourable outcome, however the positive mid term results further justify its use.
Parissis
Haralabos
H
Royal Victoria Hospital, Cardiothoracic Department, Belfast, Nothern Ireland. hparissis@yahoo.co.uk
Leotsinidis
Michael
M
Akbar
Mohammad Tauqeer
MT
Apostolakis
Efstratios
E
Dougenis
Dimitrios
D
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000401:mortality; D003404:Creatinine / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D003404:Creatinine