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The Annals of Thoracic Surgery, Vol 54, 11-18, Copyright © 1992 by The Society of Thoracic Surgeons
LL Creswell, M Rosenbloom, JL Cox, Sr Ferguson TB, NT Kouchoukos, TL Spray, MK Pasque, TB Ferguson Jr, TH Wareing and CB Huddleston
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 (83/1,298) in
1986 to 12.7% of patients (169/1,333) 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 (X2 = 16.4; p less
than 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.
ARTICLES
Intraaortic balloon counterpulsation: patterns of usage and outcome in cardiac surgery patients
Department of Surgery, Barnes Hospital, St. Louis, MO 63110.
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