Analysis of clinical outcomes of intra-aortic balloon pump use during coronary artery bypass surgery

Characteristics, morbidity and mortality factors associated with Intra-Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery patients

Objective:

The aim of our study is to analyze the characteristics, morbidity and mortality of patients requiring an Intra-Aortic Balloon Pump (IABP) in Coronary Artery Bypass Grafting (CABG).

Methods:

An analysis was done on the prospectively collected data of 1216 patients who had CABG in our center between July, 2017 and May, 2019 at our hospital. We categorized patients in to an IABP and non-IABP group on the basis of IABP use. We then compared the pre-operative, per-operative and post-operative characteristics of the two groups. We further stratified the patients according to pre-op ejection fraction (EF).

Results:

Out of 1216 patients, 135(11.10%) patients required an IABP. 70(51.9%) patients of IABP group and 699(64.7%) patients of non-IABP group had hypertension (p-value 0.0036). 23.0% had previous myocardial infarction (MI) in the IABP group and 13.8% had prior myocardial infarction (MI) in non-IABP group (p-value 0.0463). Among the patients requiring an IABP, 21(15.5%) of patients had normal EF (>50%) (P-value<0.0001), 72 (53.3%) had EF 35-50%, and 41(30.3%) patients had EF<35% (p-value <0.0001). Mortality of IABP group (19.3%) was greater than non-IABP group (2.4%) (P-value 0.00001).

Conclusions:

Use of IABP increased as the EF decreased. Rate of post-operative stroke, prolonged ICU stay, prolonged ventilation, re-opening due to bleeding and mortality was seen to be significantly higher in the IABP group.

Intra-aortic balloon pump postcardiac surgery: A literature review

Intra-aortic balloon pump (IABP) has been the most commonly used mechanical assist circulatory device in many postcardiotomy low output disorders for decades. Mechanism of IABP is based on its inflation in time of the diastolic pressure in the aortic root resulting increase in the blood and oxygen amount of the coronary artery and its deflation in left ventricular afterload during the systolic period. Prophylactic and postoperative application of IABP has been suggested by researchers, which has been commonly used in high-risk patients undertaking coronary artery bypass grafting surgery or percutaneous coronary intervention. Other researchers put forward the idea of the percutaneous IABP insertion throughout the left axillary artery as a reliable and relatively well-tolerated approach and also as a recovery tool to bridge patients with end-stage heart failure to heart transplantation. The current review was aimed to give further insight into routine IABP application by presenting the basic principles and trends in the incidence, management, role of IABP recovery, and long-lasting mortality outcomes in patients with cardiovascular disorders and discussing previous and current evidence.