title: Severe intra-aortic balloon pump complications: a single-center 12-year experience.
abstract: OBJECTIVE
  An intra-aortic balloon pump (IABP) is used routinely in high-risk patients undergoing cardiac surgery to prevent or treat low-cardiac-output syndrome and to reduce perioperative mortality. The insertion and management of IABP carry the risk of major vascular complications. The authors reviewed their database to ascertain the incidence of IABP-related severe complications.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  A teaching hospital.
  
  
  METHODS
  Ten thousand three hundred sixty-five patients scheduled for elective or emergency cardiac surgery over a 12-year period at a single center.
  
  
  METHODS
  Four hundred twenty-three patients received an IABP perioperatively. Careful preoperative screening for peripheral arterial disease, strict postoperative control, and the sheathless insertion technique to spare the arterial flow to the lower limb were performed routinely.
  
  
  RESULTS
  The use of a perioperative IABP was 0.7% at the beginning of the observation period in 1999 and 7.3% in 2010, showing a fluctuating trend. Two patients (0.47%) died of direct complications, arterial wall damage and bleeding. Immediate surgical exploration and control of bleeding were followed by multiple-organ failure and death. Vascular complications, leading to lower-limb ischemia, occurred in 4 of 423 patients (0.94%). All of them underwent urgent vascular surgery and survived. Local sepsis occurred in 2 other patients (0.47%).
  
  
  CONCLUSIONS
  These data indicate that an IABP is a valuable option in high-risk patients undergoing cardiac surgery even if not devoid of intrinsic risks for vascular complications (0.94%), septic complications (0.47%) and mortality (0.47%).
authors.affiliation: Cardiovascular Anaesthesia and Intensive Care Unit, Cardiovascular Department, San Camillo Hospital, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy. lseveri@scamilloforlanini.rm.it
authors.forename: Luca
authors.initials: L
authors.lastname: Severi
authors.forename: Paola
authors.initials: P
authors.lastname: Vaccaro
authors.forename: Marco
authors.initials: M
authors.lastname: Covotta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.forename: Rosalba
authors.initials: R
authors.lastname: Lembo
authors.forename: Antonio
authors.initials: A
authors.lastname: Menichetti
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors