Ten years single-centre experience with intra-aortic balloon pump

Abstract

Objectives The objective of this study was to investigate the patient characteristics and outcomes in 1406 patients undergoing intra-aortic balloon pump (IABP) counterpulsation.

Methods Between 1998 and 2008, 1406 consecutive patients were recorded in a prospective database. Based on the main clinical indication for IABP use, we defi ned 3 groups: group A, 630 cases of coronary ischaemia or infarction without serious left ventricular (LV) dysfunction; group B, 466 patients with left ventricular failure or cardiogenic shock; group C, 310 patients where IABP was used for miscellaneous procedures such as weaning from cardiopulmonary bypass or during high-risk angioplasty or surgery.

Results Global mortality was 28% (n = 390), with a signifi cant diff erence between group A (15%, n = 95) and group B (41%, n = 191) (P< 0.001). Mortality in group C was 34% (n = 104). Most insertions were done in the catheterization laboratory (n = 943) with subsequent mortality of 23% whereas 199 balloons were inserted in the operation room with 34% mortality. 170 balloons inserted in the intensive care unit resulted in 46% mortality (P< 0.001).

Major IABP-induced complications were 6.8% with no statistical diff erences between the three groups. Advanced age, left ventricular failure and low BMI were identifi ed as prognostic risk factors for early mortality.

Conclusions IABP deployed at an early clinical stage yields the best results, especially for acute coronary patients with preserved LV function whereas LV failure and late insertion result in worse outcome.

Key Words:

• Intra-aortic balloon pump
• IABP
• cardiogenic shock
• left ventricular failure.