Cooper G N, Singh A K, Christian F C, Cashman C, Vargas L, Karlson K E
Ann Surg. 1977 Feb;185(2):242-6. doi: 10.1097/00000658-197702000-00020.
Twenty-six patients with left main coronary (LMC) stenosis were operated upon with preoperative intra aortic balloon pump (IABP) support. There was no mortality, and no morbidity attributable to the balloon catheter. The most delicate facet of revascularization surgery in this entity is the pre-cardiopulmonary bypass phase including anesthesia induction during which blood pressure fluctuation may further diminish severely compromised coronary flow. Although systolic pressure dropped to below 100 mm Hg in 50% of patients during induction, there were only two patients with electrocardiographic evidence of perioperative myocardial infarction, and only one who needed rantic institution of cardiopulmonary bypass just after induction. Perioperative logistics were quite trouble free in all 26 patients, in marked contrast to 5 LMC patients operated upon prior to our preoperative IABP concent; 3 of these deteriorated upon induction, with two deaths resulting. Preoperative IABP is a reasonable supportive adjunct in surgery for LMC stenosis.
26例左主干冠状动脉（LMC）狭窄患者在术前主动脉内球囊反搏（IABP）支持下接受手术。无死亡病例，也无因球囊导管导致的并发症。该实体血管重建手术最棘手的方面是体外循环前阶段，包括麻醉诱导，在此期间血压波动可能会进一步减少严重受损的冠状动脉血流。尽管50%的患者在诱导期间收缩压降至100 mmHg以下，但仅有2例患者有围手术期心肌梗死的心电图证据，且仅有1例在诱导后需要立即启动体外循环。所有26例患者围手术期的后勤保障都相当顺利，这与我们术前使用IABP集中治疗之前接受手术的5例LMC患者形成了鲜明对比；其中3例在诱导时病情恶化，导致2例死亡。术前IABP是LMC狭窄手术中合理的支持辅助手段。
