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The Annals of Thoracic Surgery, Vol 20, 652-660, Copyright © 1975 by The Society of Thoracic Surgeons
JC Cleveland, AA Lefemine, I Madoff, H Black, J Amato, DH Sewell, HF Rheinlander and RJ Cleveland
Intraaortic balloon counterpulsation (IABC) was used to assist 60 patients
undergoing cardiac operations for reasons of acute left ventricular
failure (18 patients) or electively for indications in high-risk coronary
and valvular heart disease (42 patients). Nine of 18 patients achieved
hemodynamic stability when treated for acute perioperative or postoperative
cardiogenic shock. Four of these died from problems unassociated with
postoperative left ventricular failure and 5 were long-term survivors,
indicating a potential salvage of 50%. In 42 high-risk patients, IABC was
used electively to control preinfarction angina before operation (21
patients) and prophylactically to prevent postoperative low-output failure
in another 21 patients with severe coronary and valvular heart disease.
Thirty- nine, or 93%, of these patients survived. There were no deaths in
the preinfarction angina group, 1 death in the group with coronary disease
and ejection fractions less than 30%, and 2 deaths in those with valvular
heart disease and congestive failure. Seven patients developed thrombotic
or ischemic complications, but no permanent damage resulted. IABC is an
important form of assistance for any patient with preoperative,
intraoperative, or postoperative left ventricular failure and adds safety
and hemodynamic stability for the high-risk patient with preinfarction
angina or poor ventricular function.
ARTICLES
The role of intraaortic balloon counterpulsation in patients undergoing cardiac operations
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