title: Long-Term Intra-Aortic Balloon Pump Support as Bridge to Left Ventricular Assist Device Implantation.
abstract: BACKGROUND
  The intra-aortic balloon pump (IABP) can be used to bridge critically ill end-stage heart failure patients to left ventricular assist device (LVAD) implantation. However, the IABP's potential association with hemorrhagic complications raises concerns regarding its utilization in these patients.
  
  
  OBJECTIVE
  We investigated whether preoperative long-term IABP support increases hemorrhagic complications post-LVAD implantation.
  
  
  METHODS
  Ten patients undergoing IABP support prior to LVAD implantation (IABP-LVAD group) were compared with 16 who did not require IABP support (LVAD group).
  
  
  RESULTS
  Mean duration of IABP support was 25.8 days. Preoperatively, both groups were comparable in all measured parameters and indices of end-organ function. Perioperative (defined as three weeks post-LVAD implantation, including the procedure) cellular and noncellular blood transfusion requirements were similar between IABP-LVAD and LVAD groups (19.8 ± 9.95 vs. 19.76 ± 29.69 RBC units, p = 0.96; 3.8 ± 4.14 vs. 2.0 ± 6.44 plateletpheresis units p = 0.84; 23 ± 16.04 vs. 25.14 ± 37.8 fresh frozen plasma units, p = 0.45). Perioperative minimum hematocrit (33.6 ± 5.6 vs. 36.59 ± 4.8, p = 0.38) and minimum platelet count (199 ± 153 vs. 144 ± 65, p = 0.52) were similar in the two groups. Two patients in the IABP-LVAD group and three patients in the LVAD group underwent reoperation post-LVAD implantation for bleeding. Length of ICU stay was longer in the LVAD group but did not reach statistical significance (6.2 ± 6.22 days in the IABP-LVAD group versus 13.45 ± 10.95 days in the LVAD group, p = 0.06).
  
  
  CONCLUSIONS
  Long-term IABP support as a bridge to LVAD implantation is not associated with increased hemorrhagic complications post-LVAD implantation. doi: 10.1111/jocs.12759 (J Card Surg 2016;31:467-471).
authors.affiliation: 3rd Department of Cardiology, University of Athens School of Medicine, Laiko General Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Koudoumas
authors.affiliation: 3rd Department of Cardiology, University of Athens School of Medicine, Laiko General Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Malliaras
authors.affiliation: Department of Cardiac Surgery, Iaso General Hospital, Athens, Greece.
authors.forename: Stergios
authors.initials: S
authors.lastname: Theodoropoulos
authors.affiliation: 3rd Department of Cardiology, University of Athens School of Medicine, Laiko General Hospital, Athens, Greece.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kaldara
authors.affiliation: 3rd Department of Cardiology, University of Athens School of Medicine, Laiko General Hospital, Athens, Greece.
authors.forename: Chris
authors.initials: C
authors.lastname: Kapelios
authors.affiliation: 3rd Department of Cardiology, University of Athens School of Medicine, Laiko General Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Nanas
mesh_terms: D000328:Adult; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013997:Time Factors