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Ann Thorac Surg 1992;54:11-20
© 1992 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, Department of Surgery, Barnes Hospital St. Louis, Missouri USA
b The Jewish Hospital of St. Louis, Washington University, St. Louis, Missouri USA
* Address reprint requests to Dr Rosenbloom, Division of Cardiothoracic Surgery, 3105 Queeny Tower, Barnes Hospital, One Barnes Hospital Plaza, St. Louis, MO 63110.
Between January 1, 1986, and May 6, 1991, 7,884 cardiac surgical procedures requiring cardiopulmonary bypass were performed at our institution, including 672 (9.8% of adult procedures) performed in 669 patients that were associated with preoperative (n = 240), intraoperative (n = 353), or postoperative (n = 79) use of an intraaortic balloon pump. The mean age of recipients was 65.3 years (range, 16 to 89 years). Intraaortic balloon pump usage increased during the study period from 6.4% of patients ([equation]) in 1986 to 12.7% of patients ([equation]) in 1990. The relative distribution between preoperative (mean, 35.7%), intraoperative (52.5%), and postoperative (11.8%) insertion remained nearly constant during the study period. The overall operative (30-day) mortality for patients with preoperative, intraoperative, or postoperative insertion of the intraaortic balloon pump was 19.6%, 32.3%, and 40.5%, respectively (
2 = 16.4; p < 0.001). Although use of the intraaortic balloon pump in the intraoperative and postoperative settings is accompanied by a favorable outcome in most patients, the high associated mortality suggests the need for earlier use of the intraaortic balloon pump or other supportive measures such as the ventricular assist device.
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