Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Medicina (Kaunas). 2011;47(4):212-8.
Acute myocardial infarction complicated by cardiogenic shock is one of the main reasons of death in severely ill patients. One of the main indications for intra-aortic balloon counterpulsation is acute myocardial infarction complicated by cardiogenic shock. Aortic counterpulsation is associated with the risk of several important complications: bleeding, thrombosis, thrombocytopenia, limb ischemia, and aortic wall damage. The analysis of complications is necessary to better understand the course of myocardial infarction using aortic counterpulsation and to reduce the risk of complications. The aim of the study was to analyze the course of acute myocardial infarction complicated by cardiogenic shock in patients managed by intra-aortic balloon counterpulsation as well as to determine intra-aortic balloon counterpulsation-related complications.
The course of acute myocardial infarction complicated by cardiogenic shock in patients with aortic counterpulsation was analyzed. Patients were recruited from the Cardiology Intensive Care Unit, Department of Cardiology, Lithuanian University of Health Sciences, during the period of 2004-2010. The study comprised 73 patients: 30 women (41.1%) and 43 men (58.9%).
Atrial fibrillation and asystolia were the most common cardiac complications during counterpulsation. Atrioventricular block was the predominant disorder of cardiac conduction system; acute renal failure was the most common noncardiac complication. Complications such as major bleeding, infection, aortic wall damage, or amputations were not documented in our study. Successful percutaneous coronary intervention was associated with fewer complications and reduced mortality rate.
Aortic counterpulsation may be successfully employed providing significant hemodynamic support with rare major complications in a high-risk patient population. A unique finding of this study is a high rate of successful applications of aortic counterpulsation.
急性心肌梗死并发心源性休克是重症患者死亡的主要原因之一。主动脉内球囊反搏的主要适应证之一是急性心肌梗死并发心源性休克。主动脉反搏与多种重要并发症的风险相关：出血、血栓形成、血小板减少、肢体缺血和主动脉壁损伤。分析并发症对于更好地了解使用主动脉反搏治疗心肌梗死的过程以及降低并发症风险非常必要。本研究的目的是分析接受主动脉内球囊反搏治疗的急性心肌梗死并发心源性休克患者的病程，并确定与主动脉内球囊反搏相关的并发症。
分析了主动脉内球囊反搏治疗的急性心肌梗死并发心源性休克患者的病程。研究对象来自 2004 年至 2010 年期间立陶宛健康科学大学心脏病学重症监护病房心内科的患者。该研究共纳入 73 例患者：女性 30 例（41.1%），男性 43 例（58.9%）。
反搏过程中心律失常最常见的是心房颤动和停搏。房室传导阻滞是心脏传导系统最常见的障碍；急性肾衰竭是最常见的非心脏并发症。本研究未记录到大出血、感染、主动脉壁损伤或截肢等严重并发症。成功的经皮冠状动脉介入治疗与较少的并发症和降低的死亡率相关。
主动脉内球囊反搏可以在高危患者中成功应用，提供显著的血液动力学支持，且罕见严重并发症。本研究的一个独特发现是主动脉内球囊反搏的高成功率。
