Szatmary L J, Marco J, Fajadet J, Caster L
University Hospital Toulouse Purpan, Department of Hemodynamics, France.
Int J Cardiol. 1988 Apr;19(1):59-66. doi: 10.1016/0167-5273(88)90191-x.
Sixteen patients with multivessel ischemic heart disease and severely jeopardized myocardium required intra-aortic balloon counterpulsation subsequent to a deterioration in hemodynamics during or following a coronary angioplasty procedure. They had all suffered unstable angina which was refractory to intensive medical therapy, consisting of a combination of nitroglycerin, beta-adrenergic antagonists, and calcium blockers. Thirty angioplasties had been attempted (1.9 artery stem/patient) with a primary success rate of 90%. The symptoms of prolonged myocardial ischemia had disappeared, and the patient's blood pressure had normalized. No complications were associated with the use of the mechanical circulatory assistance. There were no deaths related to the procedure itself, and no myocardial infarctions. Emergency surgery was not required. One patient did die in hospital, however, due to cerebrovascular accident which occurred 4 days after removal of the mechanical circulatory support. Two also died suddenly later. One patient also required later elective coronary arterial bypass surgery and another needed repeated coronary dilation. The 12 remaining patients are asymptomatic at a follow-up with mean value of 22 months. Temporary intra-aortic diastolic counterpulsation is a useful adjunct to coronary angioplasty in patients with multivessel unstable angina and compromised hemodynamics.
16例多支血管缺血性心脏病且心肌严重受损的患者，在冠状动脉成形术期间或术后血流动力学恶化后，需要进行主动脉内球囊反搏。他们均患有难治性不稳定型心绞痛，强化药物治疗（包括硝酸甘油、β肾上腺素能拮抗剂和钙阻滞剂联合使用）无效。共尝试了30次血管成形术（每位患者1.9支动脉主干），初次成功率为90%。长时间心肌缺血的症状消失，患者血压恢复正常。使用机械循环辅助未出现并发症。未发生与手术本身相关的死亡，也未发生心肌梗死。无需进行急诊手术。然而，有1例患者在撤除机械循环支持4天后因脑血管意外在医院死亡。另有2例患者随后突然死亡。1例患者后来还需要择期冠状动脉搭桥手术，另1例患者需要重复进行冠状动脉扩张。其余12例患者在平均22个月的随访中无症状。对于多支血管不稳定型心绞痛且血流动力学受损的患者，临时主动脉内舒张期反搏是冠状动脉成形术的一种有用辅助手段。
