The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Apr 1997
Vascular complications related to intraaortic balloon counterpulsation: an analysis of ten years experience.
We have performed a retrospective review of our experience with the intraaortic balloon counterpulsation pump (IABP) during the last decade, to identify aspects of risk factors, complications, and management that affect peripheral vascular morbidity and mortality. Data from 472 patients who had the IABP inserted during the ten-year period from December 1985 to December 1995 were retrospectively reviewed. Risk factors, implantation techniques, complications, and significant variables were evaluated. ⋯ Adequate implantation and surgical explantation techniques are essential to reduce the IABP-related morbidity; 4. Identification of subclinical disease may aid in the management of subsequent acute limb ischemia; 5. The presence of peripheral vascular disease and diabetes mellitus are associated with higher ischemic complication rates.
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Thorac Cardiovasc Surg · Apr 1997
Randomized Controlled Trial Clinical TrialThe effect of preoperative intra-aortic balloon pump support in patients with coronary artery disease, poor left-ventricular function (LVEF < 40%), and hypertensive LV hypertrophy.
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. ⋯ Preoperative IABP treatment in hypertensive patients with CAD, low LVEF and LV hypertrophy who are undergoing CABG is beneficial. An improved cardiac performance pre- and postoperatively was associated with a lower rate of hospital mortality and less postoperative morbidity, as well as shorter ICU stay. The treatment is cost-beneficial.