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Ann Thorac Surg 1983;36:644-653
© 1983 The Society of Thoracic Surgeons

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Articles

Intraaortic Balloon Pump Morbidity: A Comparative Analysis of Risk Factors Between Percutaneous and Surgical Techniques

From the Departments of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, Burlington, New England Deaconess Hospital, Boston, and Harvard Medical School, Boston, MA

^* Address reprint requests to Dr. Shahian, Department of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, 41 Mall Rd, Box 541, Burlington, MA 01805

We reviewed our concurrent experience with percutaneous insertion versus surgical placement of the intraaortic balloon pump over a two-year period both to compare morbidity and to provide guidelines for the choice of method in particular patient groups and clinical settings. The effects on morbidity of sex, age, emergency placement, coexisting peripheral vascular disease, and duration of counterpulsation were determined. Sex was a highly significant factor, with low complication rates (3/29 or 10.3%) for percutaneous insertion in men and an inordinately high morbidity (12/17 or 70.6%) in women (Fisher exact test: p = 4.611 x 10^–5). This difference may be due to the smaller size of the femoral artery in women.

We conclude that percutaneous insertion is the preferred technique for most men but that direct exposure of the femoral artery should be employed in women. Given the serious morbidity encountered with each technique, there is no justification to broaden the indications for intraaortic balloon counterpulsation.

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