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2013, Number 3-4

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Rev Cubana Cardiol Cir Cardiovasc 2013; 19 (3-4)

Use of the Intra-aortic Balloon Pump in Cardiovascular Surgery

Milán GE, Fernández GRA, Silveira ÁA, Paredes CAM, Pérez NA, Nafeh AM, Cabrera RJO, Olivares AEW, Céspedes AG

Language: Spanish
References: 26
Page: 153-160
PDF size: 470.50 Kb.


ABSTRACT

Introduction: The intra-aortic balloon pump is the most used temporary ventricular assistance device in the cardiovascular surgery.
Objective: To characterize the preoperative and operative variables of patients with intra-aortic balloon pump indication and to determine the association between the timing of application of the device and other preoperative and operative characteristics with the in-hospital mortality.
Methods: We conducted a retrospective, cross-sectional study that included 73 patients (53 men, mean age 61.7±8.7) with intra-aortic balloon pump insertion of 1306 patients undergoing open heart surgery at the Hermanos Ameijeiras Hospital, between January 2008 and December 2010.
Results: In-hospital mortality was 34.2 %. Vascular complications related to the balloon pump insertion were 4.8 %. Postoperative balloon pump therapy (78.1 %) prevailed over the operative (15.1 %) and preoperative (6.8 %) insertion. Timing of intra-aortic balloon pump insertion (p=0.000), cardiopulmonary bypass time (p=0.001), aortic cross-clamp time (p=0.006) and surgical time (p=0.024) showed a significant association with the in-hospital mortality in the univariate analysis. Finally, cardiopulmonary bypass time was the only variable that showed a significant and independent association with the in-hospital mortality (OR 3.33 CI 95 % [1.57-7.09], p=0.004).
Conclusions: Cardiopulmonary bypass time increase shows a significant and independent association with the in-hospital mortality of patients with intra-aortic balloon pump therapy.


REFERENCES

  1. Centella H. El balón de contrapulsación intraaórtico como método de asistencia ventricular. Cir. Cardiov. 2009; 16:113-18.

  2. Lauga A, Perel C, D'Ortencio AO. Balón de contrapulsación intraaórtico. Insuficiencia Cardiaca 2008; 3:184-95.

  3. Kantrowitz A, Tjonneland S, Freed P, Phillips S, Butner A, Sherman J. Initial clinical experience with intra-aortic balloon pumping in cardiogenic shock. JAMA 1968; 203:113–18.

  4. Trost JC, Hillis LD. Intra-aortic balloon counterpulsation. Am J Cardiol. 2006; 97:1391-98.

  5. Santa-Cruz RA, Cohen MG, Ohman EM. Aortic counterpulsa-tion: a review of the hemodynamic effects and indications for use. Catheter Cardiovasc Interv 2006; 67:68-77.

  6. Levin RL, Degrange MA, Bruno GF, et al. Empleo Preopera-torio Preventivo de Balón de Contrapulsación (EPPreBa). Rev Argent Cardiol 2003; 71:102-08.

  7. Lorusso R, Gelsomino S, Carella R, et al. Impact of prophy-lactic intra-aortic balloon counterpulsation on postoperative outcome in high-risk cardiac surgery patients: a multicentre, propensity-score analysis. Eur J Cardiothorac Surg 2010; 38:585-91.

  8. Suzuki T, Okabe M, Handa M, Yasuda F, Miyake E. Usefull-ness of preoperative intraaortic balloon pump therapy during off-pump coronary artery bypass grafting in high-risk patients. Ann Thorac Surg 2004; 77:2056-59.

  9. Miceli A, Fiorani B, Dañéis TH, Melina G, Sinatra R. Prophy-lactic intra-aortic balloon pump in high-risk patients undergo- ing coronary artery bypass grafting: a propensity score analy-sis. Interact Cardiovasc Thorac Surg 2009; 9:291-94.

  10. Rubino AS, Onorati F, Santarpino G, et al. Early intra-aortic balloon pumping following perioperative myocardial injury im-proves hospital and mid-term prognosis. Interact Cardiovasc Thorac Surg 2009; 8:310-15.

  11. Karimi A, Movahedi N, Salehiomran A, Marzban M, Abbasi SH, Yazdanifard P. Mortality in open heart surgery with in-traaortic balloon pump support. Asian Cardiovasc Thorac Ann 2008; 16:301-04.

  12. Christenson JT, Cohen M, Ferguson JJ, et al. Trends in intraaortic balloon counterpulsation complications and out-comes in cardiac surgery. Ann Thorac Surg 2002; 74:1086-90.

  13. Stone GW, Ohman EM, Miller MF, et al. Contemporary Utili-zation and Outcomes of Intra-aortic Balloon Counterpulsation in Acute Myocardial Infarction. J Am Coll Cardiol 2003; 41:1940-45.

  14. Baskett RG, O’Connor GT, Hirsh GM, et al. A Multicenter Comparison of Intraaortic Utilization in isolated Coronary Ar-tery Bypass Graft Surgery. Ann Thorac Surg 2003; 76:1988-92.

  15. Parissis H, Leotsinidis M, Akbar MT, Apostolakis E, Dougenis D. The need for intraaortic balloon pump supporting following open heart surgery: risk analysis and outcome. J Cardiotho-rac Surg 2010; 5:20.

  16. Arafa OE, Pedersen TH, Svennevig JL, Fosse E, Geiran OR. Intraaortic balloon pump in open heart surgery: 10-year-follow-up with risk analysis. Ann Thorac Surg 1998; 65:741-47.

  17. Dyub AM, Whitlock RP, Abouzahr LL, Cina CS. Preoperative Intra-Aortic Balloon Pump in Patients Undergoing Coronary Bypass Surgery: A Systematic Review and Meta-Analysis. J Card Surg 2008; 28:79-86.

  18. Richenbacher WE, Pierce WS. Tratment of Heart failure: assisted circulation. In: Branwald E, Zipes DP, Lobby P. Heart disease. A textbook of cardiovascular medicine. 8th Edition: Philadelphia Saunders, 2001:600-14.

  19. Gutfinger DE, Ott RA, Millar M, et al. Aggressive preoperative use of intraortic balloon pump in elderly patients undergoing coronary artery. Ann Thorac Surg 1999; 67:610-13.

  20. Field ML, Rengarajan A, Khan O, Spyt T, Richens D. Pre-operative intraaortic balloon pump in patients undergoing cor-onary artery bypass grafting. Cochrane Database of System-atic Reviews 2007; 1:37-43.

  21. Holmann WL, Li Q, Kiefe C, et al. Prophylactic value of pre-incision intraaortic balloon pump: analysis of a statewide ex-perience. J Thorac Card Surg 2000; 120:1112-19.

  22. Madershahian N, Liakopoulos OJ, Wippermann J, Salehi-Gilani S, Wittwer T, Choi YH, et al. The Impact of Intraaortic Balloon Counterpulsation on Bypass Graft Flow in Patients with Peripheral ECMO. J Cardiac Surg 2009; 24:265-68.

  23. Hausmann H, Potapov EV, Koster A, et al. Prognosis After the Implantation of an Intra-Aortic Balloon Pump in Cardiac Surgery Calculated with a New Score. Circulation 2002; 106: 203-06.

  24. Tokmakoglu H, Farsak B, Gunaydin S, et al. Effectiveness of intraaortic balloon pumping in patients who were not able to be weaned from cardiopulmonary bypass after coronary ar-tery bypass surgery and mortality predictors in the periopera-tive and early postoperative period. Anadolu Kardiyol Derg 2003; 3:124-28.

  25. Creswell L, Moulton M, Cox J, Rosenbloom M. Revasculari-zation after acute myocardial infarction. Ann Thorac Surg 1995; 60:19-26.

  26. Ghali W, Ash A, Hall R, Moskowitz M. Variation in hospital rates of intraaortic balloon pump enhances cardiac perfor-mance and improves the outcome of redo CABG. Ann Thorac Surg 1997; 64:1237-44.




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