Intra aortic balloon pumping in myocardial infarction and unstable angina
From 1972 to 1979 intra aortic balloon pumping (IABP) was attempted in 181 patients; catheter insertion failed in 13 (8%). More complications occurred with prolonged treatment but all three lethal complications (2%) were related to catheter insertion. Seventy-six patients had clinical cardiogenic shock after myocardial infarction (CSMI). Haemodynamically, 23 were classified as preshock: 15 (66%) could be weaned, 12 (53%) survived over 3 months; whereas only 27/51 patients (51%) haemodynamically classified as shock could be weaned and 21 (40%) survived over 3 months. Of forty-two patients with refractory angina at rest, 41 had prompt relief of pain after IABP, and subsequently underwent coronary artery bypasss grafting (CABG). Perioperative infarction rate was 8% (4/41), perioperative mortality was 7% (3/41). Total infarction rate was 11% (5/42), and total mortality 7% (3/41). Pain relief was prompt in 14/17 patients (82%) with refractory angina after infarction. Pain persisted in three patients: all three sustained an infarction, one died. Two patients were excluded from surgery. Twelve patients underwent CABG; none died, none developed MI. In eight patients persistence of pain suggested a slowly evolving MI, IABP abolished pain in seven. Conclusion: IABP has demonstrated its efficacy both in pump failure and in refractory ischaemia. However, its use is not without risks.
|Keywords||Adult, Aged, Angina Pectoris/physiopathology/surgery/*therapy, Assisted Circulation/*methods, Coronary Artery Bypass, Coronary Vessels/surgery, Embolism/etiology, Female, Follow-Up Studies, Hemorrhage/etiology, Human, Intra-Aortic Balloon Pumping/adverse effects/*methods, Male, Middle Aged, Myocardial Infarction/mortality/physiopathology/*therapy, Shock, Cardiogenic/therapy|
Michels, R., Haalebos, M.M.P., Kint, P-P., Hagemeijer, F., Balakumaran, K., van den Brand, M.J.B.M., … Hugenholtz, P.G.. (1980). Intra aortic balloon pumping in myocardial infarction and unstable angina. European Heart Journal, 1(1), 31–43. Retrieved from http://hdl.handle.net/1765/4023