title: The use of intra-aortic balloon pump in patients undergoing heart valve replacement: outcome and risk analysis.
abstract: OBJECTIVE
  Intra-aortic balloon pump (IABP) in heart valve surgical patients is associated with a higher mortality than coronary artery bypass grafting (CABG). The study aim was to analyze the early outcome of heart valve surgical patients requiring IABP support, and to assess the risk factors for early mortality.
  
  
  METHODS
  Among a cohort of 5,786 patients undergoing heart valve replacement without CABG, 81 (1.4%) required IABP support. Data from these latter patients were collected and analyzed retrospectively, and univariate and multivariate logistic regression were applied to identify risk factors for early mortality in patients requiring IABP support.
  
  
  RESULTS
  IABP was inserted in 30 patients intraoperatively, and in 51 patients postoperatively. The overall mortality was 50.6%. Mortality in the intraoperative IABP subgroup was significantly lower than in the postoperative IABP subgroup (26.7% versus 64.7%, p = 0.001). The independent risk factors for early mortality were: age increasing by 10 years (OR 1.906, 95% CI: 1.165-3.116, p = 0.010) and pulmonary hypertension (OR 4.153, 95% CI: 1.380-12.499, p = 0.011). Intraoperative IABP insertion (OR 0.297, 95% CI: 0.100-0.876, p = 0.028) was identified as a protective factor compared to postoperative insertion.
  
  
  CONCLUSIONS
  The mortality of patients requiring IABP support after heart valve replacement was high. The efficacy of intraoperative IABP insertion was better than a postoperative mandatory use. Clearly, more attention should be paid to older patients or those with pulmonary hypertension, who may benefit less from IABP.
authors: Xi-Wu
authors: XW
authors: Zhang
authors: Zhi-Gang
authors: ZG
authors: Song
authors: Lv
authors: L
authors: Wang
authors: Fang-Lin
authors: FL
authors: Lu
authors: Liang-Jian
authors: LJ
authors: Zou
authors: Ji-Bin
authors: JB
authors: Xu
authors: Zhi-Yun
authors: ZY
authors: Xu
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D007423:Intra-Aortic Balloon Pumping; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome