Intra-aortic balloon pump use before heart surgery helps high-risk patients

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Last Updated: 2001-07-31 14:12:51 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – Preoperative placement of an intra-aortic balloon pump (IABP) in high-risk patients undergoing open heart surgery is associated with a lower mortality rate than would otherwise be expected.

Dr. Nicholas Kang and colleagues, from the Royal Perth Hospital, in Australia, assessed the outcomes of 645 consecutive patients who underwent open heart surgery from January 1998 to October 1999. Of this group, 101 patients had an IABP placed.

The IABP subgroup included 35 high-risk patients who had an IABP placed preoperatively, but nonemergently, 21 who had it placed preoperatively, emergently, and 45 who had it placed intra- or postoperatively, the authors note in the July issue of the Annals of Thoracic Surgery.

Only patients who underwent preoperative, nonemergent IABP placement had mortality rates that were lower than predicted without IABP use, the researchers state. These patients also had a significantly lower risk-adjusted mortality rate than patients who received an IABP emergently or intra/postoperatively. Three patients in the intra/postoperative IABP group experienced IABP-related complications, the authors add.

"There is growing evidence to support the use of preoperative IABPs in those patients having open hearty surgery who are thought to be 'high-risk,' on the basis of poor left ventricular function or critically ischemic hearts such as left main lesions or reoperative cases," the researchers state. The current findings provide further evidence that preoperative IABPs placed nonemergently in these patients is beneficial, they add.

"While the current trend in surgical case-mix continues, we believe that an increasing number of selected patients are likely to benefit from preoperative IABP use," Dr. Kang's team concludes.

Ann Thorac Surg 2001;72:54-57.

-Westport Newsroom 203 319 2700

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