Contemporary Outcomes of Cardiac Surgery Patients Supported by the Intra-aortic Balloon Pump

Overview

Journal Interact Cardiovasc Thorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2022 Apr 5

PMID 35381083

Authors

Roberto Lorusso

Samuel Heuts

Federica Jiritano

Roberto Scrofani

Carlo Antona

Guglielmo Actis Dato

Paolo Centofanti

Sandro Ferrarese

Matteo Matteucci

Antonio Miceli

Mattia Glauber

Enrico Vizzardi

Sandro Sponga

Igor Vendramin

Andrea Garatti

Carlo de Vincentis

Michele De Bonis

Silvia Ajello

Giovanni Troise

Margherita Dalla Tomba

Filiberto Serraino

Affiliations

Soon will be listed here.

Abstract

Objectives: Although the intra-aortic balloon pump (IABP) has been the most widely adopted temporary mechanical support device in cardiac surgical patients, its use has declined. The current study aimed to evaluate the occurrence and predictors of early mortality and complication rates in contemporary cardiac surgery patients supported by an IABP.

Methods: A multicentre, retrospective analysis was performed of all consecutive cardiac surgical patients receiving perioperative balloon pump support in 8 centres between January 2010 to December 2019. The primary outcome was early mortality, and secondary outcomes were balloon-associated complications. A multivariable binary logistic regression model was applied to evaluate predictors of the primary outcome.

Results: The study cohort consisted of 2615 consecutive patients. The median age was 68 years [25th percentile 61, 75th percentile 75 years], with the majority being male (76.9%), and a mean calculated 30-day mortality risk of 10.0%. Early mortality was 12.7% (n = 333), due to cardiac causes (n = 266), neurological causes (=22), balloon-related causes (n = 5) and other causes (n = 40). A composite end point of all vascular complications occurred in 7.2% of patients, and leg ischaemia was observed in 1.3% of patients. The most important predictors of early mortality were peripheral vascular disease [odds ratio (OR) 1.63], postoperative dialysis requirement (OR 10.40) and vascular complications (OR 2.57).

Conclusions: The use of the perioperative IABP proved to be safe and demonstrated relatively low complication rates, particularly for leg ischaemia. As such, we believe that specialists should not be held back to use this widely available treatment in high-risk cardiac surgical patients when indicated.

Citing Articles

Gao J, Zhao Q, Cheng Y Front Surg. 2024; 11:1395518.

PMID: 39290851 PMC: 11405377. DOI: 10.3389/fsurg.2024.1395518.

A Milestone in Cardiac Care: The Intra-Aortic Balloon Pump in Cardiac Surgery and Transplantation.

Perazzo A, Steffen S, Gaiotto F, Santos R, Jatene F, Lorusso R Braz J Cardiovasc Surg. 2024; 39(2):e20240991.

PMID: 38748717 PMC: 11093515. DOI: 10.21470/1678-9741-2024-0991.

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