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James S. Donahoo
Michael J. Lechman
Horace MacVaugh, III
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Ann Thorac Surg 1987;44:26-30
© 1987 The Society of Thoracic Surgeons

Articles

Transthoracic Intraaortic Balloon Pump Support: Experience in 39 Patients

William McGeehin, M.D., Feroz Sheikh, M.D. F.R.C.S.(G), James S. Donahoo, M.D., Michael J. Lechman, M.D., Horace MacVaugh, III, M.D.

From the Department of Surgery and the Division of Thoracic and Cardiovascular Surgery, Lankenau Hospital, and the Division of Cardiothoracic Surgery, Graduate Hospital, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA

From June, 1982, through July, 1985, 39 (1.5%) of 2,570 patients undergoing open-heart procedures required insertion of a transthoracic intraaortic balloon pump (IABP). In all of these patients, a percutaneous attempt failed or was contraindicated. There were 24 (62%) men and 15 (38%) women. The mean age was 64.9 years. Five patients (13%) sustained complications potentially related to the transthoracic IABP. They included mediastinal infection in 1 patient (2.5%), balloon rupture in 2 patients (5%), and cerebrovascular accidents in 4 patients (10%). The overall survival was 44%. Survival for the group of patients weaned from transthoracic IABP support was 17 (81%) of 21. There were no deaths directly related to the transthoracic IABP. The transthoracic IABP was removed under local anesthesia without sternotomy in 19 (90%) of the patients weaned and with formal sternotomy in the remaining 2 (9%). In a select group of patients requiring intraaortic balloon counterpulsation, the use of the transthoracic IABP is a reasonable second choice for patients in whom other methods of balloon support are not feasible.




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