Intra-Aortic Ballon Pump Outcome in Cardiac Surgical Patients

Intra-aortic ballon pump(IABP) is a mechanical device that has become an accepted treatment modality for patients with severely compromised hemodynamics. The present retrospective study was undertaken to identify the major survival and nonsurvival determinants of patients who were in need of intra-aortic ballon pump support after cardiac surgery. Patients & This study was conducted on 46 out of 2200 patients who underwent coronary artery bypass grafting(CABG) during one year in Tehran Shahid Rajaie Hospital and required IABP support. The patients were divided into survival(n=33) and nonsurvival(n=13) groups. Nonsurvival group was divided into 2 subgroups weaned and not weaned from IABP. Variables compared between 2 groups were: sex, age, body surface, smoking, acute myocardial infarction(AMI), diabetes mellitus, previous cardiac surgery, ejection fraction(EF), functional class according to Canadian Cardiovascular Society(CCS), duration of cardiopulmonary bypass(CPB), aortic occlusion, IABP support, mechanical ventilation and intensive care unit(ICU) stay. Differences between 2 groups were analysed via student’s t-test, chi-square test, and frequency analysis. A Pvalue of <0.05 was regarded a significant level. Overall survival and nonsurvival rate was 71.17% and 28.3% respectively. Nonsurvival group had higher rate of Canadian Cardiovascular Society functional class III, IV(P=0.03) and depressed left ventricular ejection fraction(P=0.13). This group had longer duration of cardiopulmonary bypass(P=0.01) and aortic occlusion(P=0.02). No significant difference was seen with other variables. In nonsurvival group, 6 patients weaned and 7 patients were not weaned from IABP, but all died from heart failure(P=0.009), renal failure(P=0.059), or respiratory failure(P=0.3). This data suggest that heart failure was the major cause of death in patients not weaned from IABP, and patients with EF<30% had a poorer outcome. In patients weaned from IABP, renal failure, heart failure and respiratory failure were causes of death.