title: Intra-aortic balloon pump prior to noncardiac surgery: a forgotten remedy?
abstract: High-risk cardiac patients, especially those with severe coronary artery disease, are prone to ischemic, arrhythmic and heart failure complications during urgent or emergent noncardiac surgery. The American and European guidelines endorse selective revascularization by either coronary artery bypass grafting or percutaneous coronary intervention in symptomatic ischemic patients prior to major elective surgery. However, conventional revascularization may not be suitable for certain patients requiring emergent or urgent surgery. Reported are two representative cases in which severely ischemic patients were bridged uneventfully through moderate-risk surgery by using prophylactic intra-aortic balloon pump (IABP). Prophylactic IABP should be considered for the support of ischemic patients who are severely symptomatic or hemodynamically unstable undergoing moderate-high risk surgery, who are not suitable for preoperative revascularization. This therapeutic option should be acknowledged in the relevant guidelines.
authors.affiliation: Cardiology and Cardiac Catheterization Laboratories, University Hospital, University of Medicine and Dentistry of New Jersey, 185 South Orange Ave., MSB I-538, Newark, NJ 07101, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Schmidt
authors.forename: Michael
authors.initials: M
authors.lastname: Kasper
authors.forename: Christine
authors.initials: C
authors.lastname: Gerula
authors.forename: Marc
authors.initials: M
authors.lastname: Klapholz
authors.forename: Bunyad
authors.initials: B
authors.lastname: Haider
authors.forename: Edo
authors.initials: E
authors.lastname: Kaluski
mesh_terms: D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000517:prevention & control*; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery; D007423:Intra-Aortic Balloon Pumping / Q000379:methods*; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D011300:Preoperative Care / Q000379:methods*; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome