Hashemzadeh K, Hashemzadeh S
Department of Cardiovascular Surgery, Shahid Madani Cardiovascular Research Center, Shahid Madani Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Surg (Torino). 2012 Jun;53(3):387-92. Epub 2012 May 28.
As the proportion of high-risk patients for cardiac surgery increases, use of intraaortic balloon pump (IABP) has increased, especially for acute heart failure following cardiac surgery. The aim of this prospective study was to determine risk factors of early mortality and IABP complications in patient who underwent cardiac surgery.
From March 2008 through February 2011, 106 (2.36%) patients received preoperative (N.=19) and postoperative IABP (N.=87). They included 68 (64.2%) men and 38 (35.8%) women, with a mean age 59 ± 9.6 years. Most of patients only had coronary disease. (N.=73) Prospective data collection obtained.
Fifty nine patients (59.7%) were successfully weaned from IABP support and survived to hospital discharge. Hospital mortality was 44.3%. Risk factors for hospital death were age, urgent procedure, cardiopulmonary bypass (CPB) time, and incomplete revascularization. The overall mortality between patients with preoperative IABP insertion and patients with postoperative IABP did not significantly differ (6/19 vs. 41/87, P=0.163). Early vascular complications occurred in 4 patients (3.8%) that were not significant.
The use of IABP is a safe option to support heart failure in cardiac surgery. Improved IABP technology and better surveillance have lead to increased use with lower complication rates.
随着心脏手术高危患者比例的增加，主动脉内球囊反搏（IABP）的使用也有所增加，尤其是在心脏手术后急性心力衰竭的治疗中。这项前瞻性研究的目的是确定接受心脏手术患者早期死亡和IABP并发症的危险因素。
从2008年3月至2011年2月，106例（2.36%）患者接受了术前（n = 19）和术后IABP（n = 87）治疗。其中包括68例（64.2%）男性和38例（35.8%）女性，平均年龄59±9.6岁。大多数患者仅患有冠心病（n = 73）。进行前瞻性数据收集。
59例（59.7%）患者成功撤掉IABP支持并存活至出院。医院死亡率为44.3%。医院死亡的危险因素包括年龄、急诊手术、体外循环（CPB）时间和血管重建不完全。术前插入IABP的患者与术后插入IABP的患者之间的总体死亡率无显著差异（6/19 vs. 41/87，P = 0.163）。4例（3.8%）患者发生早期血管并发症，但差异不显著。
IABP的使用是支持心脏手术中心力衰竭的一种安全选择。IABP技术的改进和更好的监测导致其使用增加且并发症发生率降低。
