Intraaortic balloon counterpulsation and coronary angioplasty in high risk coronary heart patients.

Fifteen patients with severely damaged coronary circulation required temporary intraaortic balloon counterpulsation for pharmacologically uncontrollable chest pain and poor haemodynamic state (hypotension or shock) in connection with the transluminal coronary angioplasty procedure. Twenty-five angioplasties were attempted (1.75 artery stem/patient) with a primary success rate of 96%. Emergency surgery was performed only once (6.6%) and no death occurred after the percutaneous therapeutic procedures. One patient died due to a cerebrovascular accident, two other patients suffered sudden death 1 and 3 months later. Two patients finally required coronary bypass surgery, and one patient a repeated angioplasty. In the follow-up period (mean = 11 months), two patients presented moderate symptoms of stable angina pectoris, and 10 patients (83%) remained in satisfactory condition. Temporary diastolic counterpulsation provided in patients with pharmacologically refractory myocardial ischaemia and hypotension or shock an important protection for performing transluminal angioplasty in a good condition, with improved remaining coronary circulation and haemodynamic state, assuring a favourable hospital survival.