The effect of preoperative intra-aortic balloon pump support in patients with coronary artery disease, poor left-ventricular function (LVEF < 40%), and hypertensive LV hypertrophy

The Thoracic and Cardiovascular Surgeon
Jan T ChristensonM Schmuziger

Abstract

Poor left-ventricular function, hypertension, and left-ventricular hypertrophy in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG) are associated with increased operative risks. Between June 1994 and March 1996, 33 patients undergoing CABG, were randomized into 2 groups. One group (IABP group, n = 19) received IABP treatment on average for 2 hours prior to CPB, the other group (control group, n = 14) had no preoperative IABP, Cardiac performance was measured pre- and postoperatively by Swan-Ganz catheter. Mean age was 65 years and 90% were men. All patients had a preoperative LVEF < or = 40% (mean 32.6 +/- 11.1%), 3-vessel disease, established hypertension (WHO criteria), and LV hypertrophy (ventricular mass > or = 136 g/m2 [men] or > or = 110 g/m2 [women]). Ischemia time was similar in both groups while CPB-time was shorter in the IABP group, p < 0.05. There were no hospital deaths in the IABP group, but 3 in the control group suffered postoperative low cardiac output. Nine patients (64%) in the control group required IABP support postoperatively, but only 20% of the patients in the IABP group had a shorter ICU stay, 2.4 +/- 0.9 vs. 3.4 +/- 1.1 days, p < 0.01. Cardiac index increase...Continue Reading

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