Christenson J T, Buswell L, Velebit V, Maurice J, Simonet F, Schmuziger M
Cardiovascular Surgery Unit, Hôpital de la Tour, Switzerland.
Thorac Cardiovasc Surg. 1995 Jun;43(3):129-33. doi: 10.1055/s-2007-1013786.
The intraaortic balloon pump (IABP) is usually the first mechanical device inserted for perioperative heart failure. In the present study we have reviewed our experience with 169 IABP insertions with emphasis on IABP complications, route of insertion, and identification of predictors of mortality. Between January 1, 1984 and March 31, 1993 3,591 adult patients underwent cardiac surgical procedures, 169 of whom (4.7%) had an IABP inserted preoperatively (7 patients, 4.1%), intraoperatively (109 patients, 64.5%), or postoperatively (53 patients, 31.4%). There were 137 men (81.1%) and the mean age was 60.2 +/- 8.8 years (28-78 years). Operations included 149 coronary bypass grafting (CABG) (4.6%, 149/3,209), 6 valve replacements, single or double (2.4%, 6/255), and 14 valves combined with CABG (11.0%, 14/127). The IABP was used more frequently in reoperations (14.8%, 80/542), compared to primary operations (2.9%, 89/3,049), p < 0.001. It was also more frequently used after emergency operations (50.7%, 39/77), than after elective operations (3.7%, 130/3,514), p < 0.001. In 119 patients femoral insertion was performed (13 percutaneously and 106 surgically), while 50 patients had an intraaortic insertion. The mean duration of IABP support was 50 hours (0.5-576 hours). There were 8 (4.7%) complications related to the balloon pump, all after femoral insertion (3 after transcutaneous and 5 after surgical insertions). Six of the complications occurred when the IABP was inserted intraoperatively and 2 postoperatively. The complications were 7 cases of leg ischemia (88%) and 1 groin wound infection.(ABSTRACT TRUNCATED AT 250 WORDS)
主动脉内球囊反搏泵（IABP）通常是围手术期心力衰竭时插入的首个机械装置。在本研究中，我们回顾了169例IABP插入的经验，重点关注IABP并发症、插入途径以及死亡率预测因素的识别。1984年1月1日至1993年3月31日期间，3591例成年患者接受了心脏外科手术，其中169例（4.7%）术前（7例，4.1%）、术中（109例，64.5%）或术后（53例，31.4%）插入了IABP。有137名男性（81.1%），平均年龄为60.2±8.8岁（28 - 78岁）。手术包括149例冠状动脉旁路移植术（CABG）（4.6%，149/3209）、6例单瓣或双瓣置换术（2.4%，6/255）以及14例瓣膜置换术联合CABG（11.0%，14/127）。与初次手术（2.9%，89/3049）相比，IABP在再次手术中使用更频繁（14.8%，80/542），p < 0.001。在急诊手术后使用也比择期手术后更频繁（50.7%，39/77），而择期手术为（3.7%，130/3514），p < 0.001。119例患者进行了股动脉插入（13例经皮插入，106例手术切开插入），50例患者进行了主动脉内插入。IABP支持的平均持续时间为50小时（0.5 - 576小时）。有8例（4.7%）与球囊泵相关的并发症，均发生在股动脉插入后（经皮插入后3例，手术切开插入后5例）。6例并发症发生在术中插入IABP时，2例发生在术后。并发症包括7例腿部缺血（88%）和1例腹股沟伤口感染。（摘要截断于250字）
