Cleveland J C, Lefemine A A, Madoff I, Black H, Amato J, Sewell D H, Rheinlander H F, Cleveland R J
Ann Thorac Surg. 1975 Dec;20(6):652-60. doi: 10.1016/s0003-4975(10)65758-x.
Intraaortic balloon counterpulsation (IABC) was used to assist 60 patients undergoing cardiac operations for reasons of acute left ventricular failure (18 patients) or electively for indications in high-risk coronary and valvular heart disease (42 patients). Nine of 18 patients achieved hemodynamic stability when treated for acute perioperative or postoperative cardiogenic shock. Four of these died from problems unassociated with postoperative left ventricular failure and 5 were long-term survivors, indicating a potential salvage of 50%. In 42 high-risk patients, IABC was used electively to control preinfarction angina before operation (21 patients) and prophylactically to prevent postoperative low-output failure in another 21 patients with severe coronary and valvular heart disease. Thirty-nine, or 93%, of these patients survived. There were no deaths in the preinfarction angina group, 1 death in the group with coronary disease and ejection fractions less than 30%, and 2 deaths in those with valvular heart disease and congestive failure. Seven patients developed thrombotic or ischemic complications, but no permanent damage resulted. IABC is an important form of assistance for any patient with preoperative, intraoperative, or postoperative left ventricular failure and adds safety and hemodynamic stability for the high-risk patient with preinfarction angina or poor ventricular function.
主动脉内球囊反搏（IABC）用于辅助60例因急性左心室衰竭（18例）而接受心脏手术的患者，或因高危冠状动脉和瓣膜性心脏病而择期手术的患者（42例）。18例因急性围手术期或术后心源性休克接受治疗的患者中，有9例实现了血流动力学稳定。其中4例死于与术后左心室衰竭无关的问题，5例为长期存活者，提示潜在挽救率为50%。在42例高危患者中，IABC被选择性地用于术前控制梗死前心绞痛（21例），并预防性地用于另外21例患有严重冠状动脉和瓣膜性心脏病的患者，以防止术后低心排血量衰竭。这些患者中有39例（93%）存活。梗死前心绞痛组无死亡病例，冠心病且射血分数低于30%的患者中有1例死亡，瓣膜性心脏病且伴有充血性心力衰竭的患者中有2例死亡。7例患者出现血栓形成或缺血性并发症，但未造成永久性损害。IABC是术前、术中和术后左心室衰竭患者的一种重要辅助形式，为梗死前心绞痛或心室功能不良的高危患者增加了安全性和血流动力学稳定性。
