Intraaortic Balloon Pump in Open Heart Surgery: Comparisons of the Results Obtained in the Preoperative, Intraoperative and Postoperative Implantations Periods
Fatih Öztürk1
, Kudret Atakan Tekin2, Mehmet Erdem Toker2
1Marmara University School of Medicine, Department of Cardiovascular Surgery, Istanbul, Turkey
2Kartal Kosuyolu High Speciality Training and Research Hospital, Clinic of Cardiovascular Surgery, Istanbul, Turkey
Keywords: Cardiac surgery; intra-aortic balloon pump; low cardiac output syndrome
Abstract
Introduction: No exact consensus exists on the timing of the placement of an intraaortic balloon pump (IABP), yet still, it is the most common mechanical support device used in patients requiring open heart surgery. The purpose of this study was to investigate the results of the implantation of IABP in three different periods as preoperative, intraoperative, and postoperative and to compare the results obtained in these periods.
Patients and Methods: This study included 193 patients undergoing open-heart surgery with IABP support between January 2014 and December 2016. The patients were divided into three groups as preoperative period, intraoperative period and postoperative period, based on the beginning of IABP support. The patients were compared in terms of preoperative characteristics, surgical data and postoperative results.
Results: Of the 193 patients, 32 (16.5%) received preoperative, 64 (33.1%) intraoperative, and 97 (50.2%) postoperative IABP support. The length of ICU stay (20.15 ± 23 days) was longer for the postoperative group compared with the preoperative (7.63 ± 9.8 days) and intraoperative (12.98 ± 25 days) groups (p1: 0.005; p2: 0.007 respectively, p< 0.05). The new dialysis incidence rate in the pre-, intra-, and postoperative periods was 9.4%, 23.4%, and 33.0%, respectively. The veno-arterial extracorporeal membrane oxygenation implantation rate in the preoperative, intraoperative, and postoperative groups was 3.1%, 23.4%, and 22.7%, respectively. The incidence of hospital mortality was 25.0% in the preoperative group, which was significantly lower compared to the intraoperative (54.7%) and the postoperative groups (70.1%) (p1: 0.011; p2: 0.000 respectively, p< 0.05).
Conclusion: Any delay in insertion of IABP may cause progressive hemodinamic deteoriation. Determining the indication of implantation may even be difficult in some clinical scenarios. IABP support should be started without delay in the intraoperative period when a second inotropic support is needed and the patient has difficulty in weaning from CPB.
Cite this article as: Öztürk F, Tekin KA, Toker ME. Intraaortic balloon pump in open heart surgery: comparisons of the results obtained in the preoperative, intraoperative and postoperative implantation periods.