[Intra-aortal balloon counterpulsation in acute myocardial infarction, ischemic left ventricle insufficiency and treatment refractory angina pectoris].

Intraaortic balloon counterpulsation (IABP) was employed between 1977 and 1988 in 132 patients (37 women and 95 men; mean age 60 +/- 9.9 years) with coronary heart disease. Indications for IABP were cardiogenic shock in 93, markedly impaired left ventricular function in 13, and treatment-refractory angina in 26. The hospital mortality rate among those patients in cardiogenic shock was 54%. The mortality rate among the 47 patients who had additional procedures (percutaneous transluminal coronary angioplasty or operation) was 40%, significantly lower than that in 46 patients without further procedure (67%). Complications of IABP occurred in 20% of patients (bleeding, vascular injury, ischaemia in the legs, embolism or infection). The complication rate was, however, reduced to 10% in the last few years by improvements in placement technique and materials. Introduction and placement of the balloon catheter is simple, rapid and reliable. The initially high success rate is particularly valuable for those patients in whom further therapeutic measures can be undertaken.