Preventive Use of Intra-Aortic Balloon Pump in Patients Undergoing High-Risk Coronary Artery Bypass Grafting: A Retrospective Study
Jingchao Zhang, Yan Lang, Longhui Guo, Xiaodong Song, Liliang Shu, Gang Su, Hai Liu, Jing Xu
Department of Cardiac Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
Med Sci Monit 2015; 21:855-860
Coronary artery bypass grafting (CABG) is an important therapeutic measure for CHD patients. The patients who score more than 12 EuroSCORE points cannot achieve good results because of their low cardiac output and delicate left ventricular function. Therefore, use of an intra-aortic balloon pump (IABP) is essential for coronary surgical patients in the peri-operative period. At present, there is no unified standard about when to insert an IABP. This study aimed to compare the short-term clinical outcomes of the IABP inserted in the preoperative condition with its use in the emergency condition for extremely high-risk patients.
Material and Methods: IABP support time, respirator support time, and ICU stay time were significantly shorter (all p<0.05) in the preoperative IABP group compared to the emergency IABP group, and the rates of low cardiac output syndrome (LCOS), acute myocardial infarction, and acute kidney injury in the preoperative group were also significantly lower in the preoperative IABP group (all p<0.05). There were no significant differences in IABP-related complications and the mortality (p=0.106) between two groups.
Results: Compared to the emergency IABP group, the IABP support time, respirator support time and ICU stay time were significantly lower in the preoperative IABP group (all p<0.05), and the rates of LCOS, acute myocardial infarction, and acute kidney injury in the preoperative group were also significantly lower (all p<0.05). There were no significant differences in IABP-related complications and the mortality (p=0.106) between the 2 groups.
Conclusions: For high-risk patients with CABG, preoperative IABP insertion is a safe and effective measure.
Keywords: Coronary Artery Bypass, Hospitalization, Intra-Aortic Balloon Pumping, Risk Factors