Original articleAdult cardiacPreoperative Intraaortic Balloon Pumping Improves Outcomes for High-Risk Patients in Routine Coronary Artery Bypass Graft Surgery
Section snippets
Patients
Between January 2003 and May 2007, 714 patients underwent CABG at our academic institution. The present study compares the clinical and biochemical findings of 111 of these patients who underwent isolated CABG, who had a EuroSCORE of 12 or greater, and who received IABP support preoperatively (high-risk, group A) with those of 130 of these patients who underwent elective CABG, who had a EuroSCORE of 5 less, and who did not receive IABP support preoperatively (low-risk, group B). Patients
Results
The two groups showed significant differences in several demographic and clinical preoperative variables (Table 1), whereas intraoperative data and the release of lactate, troponin I, CK, and CK-MB mass from the coronary sinus were similar (Table 2). Accordingly, no differences were recorded in peripheral lactate, troponin I, CK, or CK-MB mass at all times. In particular, both high-risk and low-risk patients showed slight augmentation of postoperative enzymes, never reaching statistical
Comment
With the enormous growth of interventional cardiology in recent decades, patients coming to myocardial revascularization surgery are now more likely to have end-stage disease, with more-ischemic and energy-depleted hearts, compared with the era of coronary angioplasty and stenting [15]. Patients undergoing CABG are now older and sicker and have poorer ventricular function and more extensive disease [1, 2, 15]. Correspondingly, patients with failed angioplasty after myocardial infarction or
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Cited by (35)
Management of Challenging Cardiopulmonary Bypass Separation
2020, Journal of Cardiothoracic and Vascular AnesthesiaLow-Cardiac-Output Syndrome After Cardiac Surgery
2017, Journal of Cardiothoracic and Vascular AnesthesiaEfficacy and safety of preoperative intra-aortic balloon pump use in patients undergoing cardiac surgery: A systematic review and meta-analysis
2016, International Journal of CardiologyCitation Excerpt :IABP was associated with a significantly shorter duration in length of hospital stay (WMD − 3.25 days; 95% CI: − 5.18 to − 1.33 days; P = 0.0009), there was no difference between groups in observational studies with a WMD of − 0.04 day (95% CI: − 1.39 to 1.32 day; P = 0.96). IABP-related complications were available only in 3 RCTs [8,9,11] and 13 observational studies [5,6,13,14,32,34,35,39–41,43–45] and are shown in Tables 2 and 3. Leg ischemia occurred in 5 (6%) of 84 patients with IABP pre-cardiac surgery in RCTs and in 11 (2%) of 601 patients in observational studies.
Outcome of emergency coronary artery bypass grafting
2015, Journal of Cardiothoracic and Vascular AnesthesiaSingle-centre experience with perioperative use of intraaortic balloon pump in cardiac surgery
2014, Heart Lung and CirculationCitation Excerpt :The mortality as per time of balloon insertion was reported as preoperative 18.2%, intraoperative 33.3% and postoperative 58.3% in their study [14]. Many other studies showed a positive effect of prophylactic preoperative IABP insertion to improve the outcomes [11–13,15–17]. Given results led to the suggestion of preoperative prophylactic IABP insertion in high risk patients before observing any haemodynamic compromise [7].