Effect of preoperative intra-aortic balloon pump insertion in patients undergoing off-pump coronary artery bypass grafting: A retrospective cohort study
10.7507/1007-4848.202007059
- VernacularTitle:术前预防性应用主动脉内球囊反搏治疗不停跳冠状动脉旁路移植术患者疗效的回顾性队列研究
- Author:
Lei FANG
1
;
Pishan WANG
1
;
Qilin JIN
1
;
Po WANG
1
;
Xiangkuan MENG
1
Author Information
1. Department of Cardiac Surgery, Capital Medical University Daxing Teaching Hospital, Beijing, 102600, P.R.China
- Publication Type:Journal Article
- Keywords:
Off-pump coronary artery bypass grafting;
intra-aortic balloon pump;
preoperative insertion;
clinical effect
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(10):1229-1233
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of preoperative intra-aortic balloon pump (IABP) insertion in patients with off-pump coronary artery bypass grafting (OPCABG) surgery. Methods The clinical data of 130 patients who underwent OPCABG with IABP from 2015 to 2019 in our hospital were retrospectively analyzed. The patients were divided into two groups, including a group A (preoperative IABP insertion, n=72) and a group B (emergent IABP insertion, n=58). There were 42 males and 30 females in the group A with an average age of 60-72 (65.0±5.2) years. There were 32 males and 26 females in the group B with an average age of 56-73 (62.3±7.6) years. The in-hospital mortality rate and prognosis were compared between the two groups. Results The in-hospital mortality rate in the group A (4.2%) was significantly lower than that in the group B (12.1%, P=0.002). The IABP time (40.8±10.3 min vs. 65.3±15.6 min), mechanical ventilation time (18.7±6.1 min vs. 48.7±10.5 min) and ICU stay time (48.1±7.8 min vs. 90.2±21.3 min) of the group A were shorter than those of the group B (P<0.05). The number of bypass grafts was not significantly different between the two groups (3.6±1.2 vs. 3.8±1.0, P=0.387). Multivariable logistic regression analysis indicated that independent risk factors for in-hospital mortality included age [OR=1.04, 95%CI (1.01, 1.10), P=0.030], female [OR=2.56, 95%CI (1.53, 6.12), P=0.000] and left ventricular end-diastolic diameter [OR=1.05, 95%CI (1.01, 1.13), P=0.030]. Preoperative IABP support was the protective factor [OR=0.17, 95%CI (0.01, 0.78), P=0.005]. Conclusion Patients undergoing OPCABG with preoperative IABP insertion may reduce in-hospital mortality rate and improve outcomes.
