M H Millat1, E W J Cameron. 1. Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, UK. mhmillat@hotmail.com
Abstract
BACKGROUND: Oesophagogastrectomy for carcinoma has a high operative mortality rate. Patients are elderly and ischaemic heart disease (IHD) is a recognised and frequent risk factor. AIM: To illustrate the use of the intra-aortic balloon pump (IABP) as prophylaxis against cardiac complications in a group of such patients. METHODS: Five patients aged from 63 to 78 years were presented with operable adenocarcinoma of the oesophagus. They had IHD of a severity thought to pose a risk of myocardial infarction (MI) and/or failure at the time of oesophagogastrectomy. With the induction of anaesthesia, the IABP was inserted and left in situ for up to 24 hours. RESULTS: There were no major adverse perioperative cardiac events. Four patients were discharged from hospital on the eighth and one on the tenth postoperative day. CONCLUSION: The prophylactic use of IABP has a potential role in the prevention of cardiac complications in patients with IHD undergoing high risk non-cardiac surgery.
BACKGROUND: Oesophagogastrectomy for carcinoma has a high operative mortality rate. Patients are elderly and ischaemic heart disease (IHD) is a recognised and frequent risk factor. AIM: To illustrate the use of the intra-aortic balloon pump (IABP) as prophylaxis against cardiac complications in a group of such patients. METHODS: Five patients aged from 63 to 78 years were presented with operable adenocarcinoma of the oesophagus. They had IHD of a severity thought to pose a risk of myocardial infarction (MI) and/or failure at the time of oesophagogastrectomy. With the induction of anaesthesia, the IABP was inserted and left in situ for up to 24 hours. RESULTS: There were no major adverse perioperative cardiac events. Four patients were discharged from hospital on the eighth and one on the tenth postoperative day. CONCLUSION: The prophylactic use of IABP has a potential role in the prevention of cardiac complications in patients with IHD undergoing high risk non-cardiac surgery.