Effectiveness of intraaortic balloon pumping in patients who were not able to be weaned from cardiopulmonary bypass after coronary artery bypass surgery and mortality predictors in the perioperative and early postoperative period.

OBJECTIVE: The intraaortic balloon pump (IABP) is usually the first choice of mechanical device used for perioperative cardiac failure. The aim of this retrospective study was to determine the effectiveness of intraoperative IABP use in patients who could not be weaned from cardiopulmonary bypass (CPB) and to determine the possible perioperative and early postoperative prognostic factors for mortality.

METHODS: Between June 1992-December 2001 a total of 69 patients who underwent coronary artery bypass grafting and required IABP support in weaning from CPB due to cardiac pump failure were included into the study. The mean age was 61.9+/-7.5 years. The effectiveness of IABP and preoperative, operative and postoperative risk factors for mortality were evaluated retrospectively.

RESULTS: Following the insertion of IABP, 59 (85.5%) patients could be weaned from CPB whereas 10 patients (14.5%) could not. In the early postoperative period, 13 (22%) patients died due to cardiac pump failure. The average in-hospital mortality rate for patients who were treated with an IABP was found as 33.3% (23 patients). Univariate analysis identified left ventricular enddiastolic pressure, ventricular performance score, urgent operation and perioperative myocardial infarction as the risk factors for early death. The minor and major IABP related complications occurred in only 8 patients.

CONCLUSION: Due to the contributory effects, effectiveness and low complication rate, IABP may be used in patients who cannot be weaned from CPB.