title: Prophylactic Intra-Aortic Balloon Pump Before Ventricular Assist Device Implantation Reduces Perioperative Medical Expenses and Improves Postoperative Clinical Course in INTERMACS Profile 2 Patients.
abstract: BACKGROUND
  Although intra-aortic balloon pump (IABP) is sometimes used before cardiac surgery to achieve better outcome in high-risk patients, the clinical impact of prophylactic IABP support before left ventricular assist device (LVAD) implantation in patients with worsening hemodynamics was unknown.
  
  
  RESULTS
  We enrolled 22 patients with worsening hemodynamics who had received IABP support before LVAD (IABP group), and also enrolled 22 patients receiving neither IABP nor extracorporeal membrane oxygenation before LVAD, who were selected on propensity score matching (non-IABP group). Although both groups had similar preoperative background, the IABP group had shorter postoperative intensive care unit (ICU) stay, and more improved hemodynamics (P<0.05 for all). Serum total bilirubin and creatinine decreased significantly in the IABP group compared with the non-IABP group during 1 month after LVAD implantation (P<0.05 for both). Medical expenses during perioperative ICU stay were significantly lower in the IABP group compared with the non-IABP group, even including the cost of preoperative IABP support (P<0.05).
  
  
  CONCLUSIONS
  Prophylactic IABP support in heart failure patients with worsening hemodynamics improves post-LVAD clinical course and reduces perioperative medical expenses.
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nitta
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Kan
authors.initials: K
authors.lastname: Nawata
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D003365:Costs and Cost Analysis; D003404:Creatinine / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000191:economics* / Q000601:surgery; D006353:Heart-Assist Devices / Q000191:economics*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000191:economics* / Q000379:methods; D008297:Male; D008875:Middle Aged
chemical_list: D003404:Creatinine; D001663:Bilirubin