Osterne E C, Alexim G A, da Motta V P, Lins R M, Carvalho E F, Carneiro M V, de Morais E R, Brick A V
Hospital das Forças Armadas, Brasília, Brazil.
Arq Bras Cardiol. 1999 Aug;73(2):191-200. doi: 10.1590/s0066-782x1999000800007.
To evaluate the use of the intraaortic balloon (IAoB) in association with coronary angioplasty in high-risk patients.
Fourteen high-risk patients unresponsive to clinical therapy and with formal contraindication to surgical revascularization were treated by coronary angioplasty, most of which was followed by stenting. All procedures were performed with circulatory support with the IAoB. This study reports the early results and the late findings after 12 months of follow-up. Six patients had multivessel coronary disease; of these, four had left main equivalent lesions and two had unprotected left main coronary artery disease, one of whom had severe "end-vessel" stenosis and the other was a patient with Chagas' disease with single-vessel lesion. Eleven patients had a left ventricular ejection fraction < 30%.
In 100% of the patients, the procedures were initially successful. Two patients had severe bleeding during the withdrawal of the left femoral sheath. At the end of twelve months, 4 patients were asymptomatic and the others were clinically controlled. There were two late deaths in the 7th and 11th months.
The combined use of the intraaortic balloon pump and percutaneous coronary angioplasty in high-risk patients with acute ischemic syndromes provides the necessary hemodynamic stability to successfully perform the procedures.
评估主动脉内球囊（IAoB）在高危患者冠状动脉血管成形术中的应用。
14例对临床治疗无反应且有外科血运重建正式禁忌证的高危患者接受了冠状动脉血管成形术，大多数患者随后进行了支架置入术。所有手术均在IAoB循环支持下进行。本研究报告了早期结果以及随访12个月后的晚期发现。6例患者患有多支冠状动脉疾病；其中，4例有左主干等同病变，2例有无保护左主干冠状动脉疾病，其中1例有严重的“终末血管”狭窄，另1例是患有单支血管病变的恰加斯病患者。11例患者的左心室射血分数<30%。
100%的患者手术最初成功。2例患者在拔除左股动脉鞘时出现严重出血。在十二个月末，4例患者无症状，其他患者病情得到临床控制。在第7个月和第11个月有2例晚期死亡。
主动脉内球囊泵与经皮冠状动脉血管成形术联合应用于急性缺血综合征高危患者，可为成功实施手术提供必要的血流动力学稳定性。
