Clinical and hemodynamic results of intraortic balloon counterpulsation and surgery for cardiogenic shock

American Heart Journal
J BardetY Bouvrain

Abstract

Forty-two patients with cardiogenic shock (CS) secondary to myocardial infarction were treated with intra-aortic balloon pumping (I.A.B.P.). In 14 patients C.S. was associated with ventricular septal defect (V.S.D.) and in four with mitral regurgitation (M.R.) secondary to rupture of the posterior papillary muscle. All patients were resistant to conventional medical therapy. Shock was reversed in 20 of the 24 patients in C.S. without mechanical complications. After 24 to 48 hours of I.A.B.P., cardiax index (C.I.) increased from 1.38 to 2.00 L./min./M2, systolic arterial pressure (S.A.P.) from 83 to 96 mm. Hg, urinary output (U.O.) from 10 to 56 ml. per hour, and pulmonary wedge pressure (P.W.P.) decreased from 22 to 16 mm. Hg. Three patients treated with I.A.B.P. alone survived more than 1 year; of the 13 patients who were balloon dependent, four have undergone emergency surgical procedures and two were long-term survivors. In all patients with mechanical complications, I.A.B.P. resulted in significant clinical and hemodynamic improvement. P.W.P. decreased from 19 to 15 mm. Hg, and U.O. increased from 13 to 38 ml. per hour while S.A.P. remained unchanged. In patients with V.S.D. the pulmonary/systemic flow ratio (P/S) declined ...Continue Reading

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Citations

Jul 1, 1973·Circulation·R C LeinbachC A Sanders
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Related Concepts

Arterial Pulse Pressure
Protein S Deficiency
Lung
Diastolic Blood Pressure
Myocardial Infarction
Mitral Valve Insufficiency
Long-Term Survivors
Intra-Aortic Balloon Pumping
Coronary Artery Bypass Surgery
Aorta

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Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.