Christenson Jan T, Sierra Jorge, Romand Jacques-André, Licker Marc, Kalangos Afksendyios
Department of Cardiovascular Surgery, University Hospital of Geneva, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.
Asian Cardiovasc Thorac Ann. 2007 Oct;15(5):408-12. doi: 10.1177/021849230701500510.
Intraaortic balloon counterpulsation is an established and efficient therapy. Limb ischemia is the most common complication. The impact of treatment duration on balloon-related complications was analyzed retrospectively in 135 patients who underwent balloon counterpulsation between 1998 and 2004. Thirty high-risk coronary patients required preoperative intraaortic balloon therapy, 41 were in preoperative cardiogenic shock, and 64 needed support for difficulties in weaning from cardiopulmonary bypass. No balloon-related mortality occurred. The overall balloon-related complication rate was 20/135 (14.8%); 18 had limb ischemia, of whom 6 (4.4%) required vascular interventions. Intraaortic balloon treatment time was significantly longer in patients who developed limb ischemia (99.8 +/- 54.1 h) compared to those who did not (34.4 +/- 30.4 h). Preoperative therapy had short treatment times and few complications. Intraaortic balloon pumping provides effective circulatory support with a low complication rate. A clear relationship was established between duration of treatment and balloon-related complications. Independent risk factors for balloon-related complications were long treatment time, acute myocardial infarction, age over 65 years, and ejection fraction less than 0.30.
主动脉内球囊反搏是一种成熟且有效的治疗方法。肢体缺血是最常见的并发症。回顾性分析了1998年至2004年间接受球囊反搏治疗的135例患者治疗持续时间对球囊相关并发症的影响。30例高危冠心病患者术前需要主动脉内球囊治疗，41例处于术前心源性休克状态，64例因脱离体外循环困难需要支持治疗。未发生与球囊相关的死亡病例。总的球囊相关并发症发生率为20/135（14.8%）；18例发生肢体缺血，其中6例（4.4%）需要进行血管干预。发生肢体缺血的患者主动脉内球囊治疗时间（99.8±54.1小时）显著长于未发生肢体缺血的患者（34.4±30.4小时）。术前治疗时间短且并发症少。主动脉内球囊泵提供有效的循环支持，并发症发生率低。治疗持续时间与球囊相关并发症之间建立了明确的关系。球囊相关并发症的独立危险因素为治疗时间长、急性心肌梗死、年龄超过65岁和射血分数低于0.30。
