Peri-operative application of intra-aortic balloon pumping reduced in-hospital mortality of patients with coronary artery disease and left ventricular dysfunction.
10.1097/CM9.0000000000000178
- Author:
Xiao-Yi HE
1
;
Chang-Qing GAO
Author Information
1. Department of Cardiovascular Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.
- Publication Type:Journal Article
- MeSH:
Aged;
Coronary Artery Bypass;
Coronary Artery Disease;
mortality;
surgery;
therapy;
Female;
Hospital Mortality;
Humans;
Intra-Aortic Balloon Pumping;
methods;
Male;
Middle Aged;
Multivariate Analysis;
Retrospective Studies;
Ventricular Dysfunction, Left;
mortality;
surgery;
therapy;
Ventricular Function, Left;
physiology
- From:
Chinese Medical Journal
2019;132(8):935-942
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:There are few reports of peri-operative application of intra-aortic balloon pumping (IABP) in patients with coronary artery disease (CAD) and different grades of left ventricular dysfunction. This study aimed to analyze the early outcomes of peri-operative application of IABP in coronary artery bypass grafting (CABG) among patients with CAD and left ventricular dysfunction, and to provide a clinical basis for the peri-operative use of IABP.
METHODS:A retrospective analysis of 612 patients who received CABG in the General Hospital of People's Liberation Army between May 1995 and June 2014. Patients were assigned to an IABP or non-IABP group according to their treatments. Logistic regression analysis was performed to investigate the influence of peri-operative IABP implantation on in-hospital mortality. Further subgroup analysis was performed on patients with severe (ejection fraction [EF] ≤ 35%) and mild (EF = 36%-50%) left ventricular dysfunction.
RESULTS:Out of 612 included subjects, 78 belonged to the IABP group (12.7%) and 534 to the non-IABP group. Pre-operative left ventricular EF (LVEF) and EuroSCOREII predicted mortality was higher in the IABP group compared with the non-IABP group (P < 0.001 in both cases), yet the two did not differ significantly in terms of post-operative in-hospital mortality (P = 0.833). Regression analysis showed that IABP implantation, recent myocardial infarction, critical status, non-elective operation, and post-operative ventricular fibrillation were risk factors affecting in-hospital mortality (P < 0.01 in all cases). Peri-operative IABP implantation was a protective factor against in-hospital mortality (P = 0.0010). In both the severe and mild left ventricular dysfunction subgroups, peri-operative IABP implantation also exerted a protective role against mortality (P = 0.0303 and P = 0.0101, respectively).
CONCLUSIONS:Peri-operative IABP implantation could reduce the in-hospital mortality and improve the surgical outcomes of patients with CAD with both severe and mild left ventricular dysfunction.
