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DOI: 10.1055/s-0030-1269106
Preoperative placement of an Intra-Aortic Balloon Pump (IABP) in patients with acute coronary syndrome (ACS): A follow-up
Objectives: Effectiveness of preoperative intra-aortic balloon pump (IABP) placement concerning the survival rate and postoperative complications for high-risk patients suffering from ACS.
Methods: We present data of 115 high risk patients (77% males, 23% females) undergoing coronary bypass surgery with preoperative placement of an IABP. 40% of the patients were suffering from unstable angina, 33.9% from STEMI and 26.1% from NSTEMI. In all patients, initial emergency treatment was provided by a team of cardiologists following a standardized protocol including oxygen, intravenous nitroglycerin, heparin and antiplatelet drugs (acetylsalicylic acid or Clopidogrel). Primary outcome was 30-day mortality rate; secondary outcome was accumulation of clinical parameters. Results: No complications could be assessed related to the use of the IABP. The 30-day mortality rate was 5.2%. Removal of the IABP was on pod 1 in 5% and on pod 2 in 55%. 63% of the patients were discharged between pod 7 and 11 (average pod 9). In nearly 50% of the patients, it was necessary to substitute red blood cells (RBCs). Furthermore, there was no increase in the need of transfusions of RBCs compared to a controlled CABG-group. Preoperatively, 7.8% of the patients suffered from renal insufficiency. In comparison with the above mentioned control group, there was no increase in acute renal injury.
Conclusion: Because of ethical reasons a randomization (patients with or without IABP) is not possible. Implantation of an IABP in high-risk patients is a safe method to treat these seriously ill patients suffering from ACS undergoing coronary bypass surgery.