OBJECTIVES: The crucial decision to progress from pharmacological treatment of acute decompensated heart failure to institution of assist device or transplantation begins with evaluation of the chances for a successful recovery. We tested whether the intra-aortic balloon counterpulsation (IABP) could give us the necessary time for clinical decision-making and preserve adequate circulation until it is made. METHODS: We assessed 11 dilated cardiomyopathy patients of NYHA class IV, listed for heart transplantation or a ventricular assist device (VAD), who had conventional IABP placed. Heart function prior to and after IABP insertion as well as hemodynamics, end-organ function (renal and hepatic), frequency of complications and clinical outcomes were assessed. RESULTS: The duration of intra-aortic balloon pump insertion ranged from 72 to 360 h (mean 181.54+/-81.65). After 48 h of intra-aortic balloon pump support, there was a significant increase of mean systemic arterial pressure from 74.5+/-9.6 to 82.3+/-4.7 mmHg (P=0.02), and ejection fraction from 14.7+/-6.4 to 21.0+/-8.6 (P=0.014). Meanwhile improvement of cardiac index, pulmonary wedge pressure and end-organ perfusion markers did not reach statistical significance. Three patients were successfully weaned off the balloon and recovered without additional interventions, two patients were transplanted and three were supported with counterpulsation until the implantation of assist device. Three patients died due to progressive heart failure, two after IABP removal and one after VAD implantation. There was no incidence of infection, limb ischemia, thrombus, or embolic complications. CONCLUSIONS: Our data showed that intra-aortic balloon pump support may be successfully and safely used in the acute decompensated dilated cardiomyopathy patients, as an urgent measure of cardiac support, to stabilize the patient and maintain organ perfusion until transplant is available, VAD is placed or patient is weaned from IABP.
OBJECTIVES: The crucial decision to progress from pharmacological treatment of acute decompensated heart failure to institution of assist device or transplantation begins with evaluation of the chances for a successful recovery. We tested whether the intra-aortic balloon counterpulsation (IABP) could give us the necessary time for clinical decision-making and preserve adequate circulation until it is made. METHODS: We assessed 11 dilated cardiomyopathypatients of NYHA class IV, listed for heart transplantation or a ventricular assist device (VAD), who had conventional IABP placed. Heart function prior to and after IABP insertion as well as hemodynamics, end-organ function (renal and hepatic), frequency of complications and clinical outcomes were assessed. RESULTS: The duration of intra-aortic balloon pump insertion ranged from 72 to 360 h (mean 181.54+/-81.65). After 48 h of intra-aortic balloon pump support, there was a significant increase of mean systemic arterial pressure from 74.5+/-9.6 to 82.3+/-4.7 mmHg (P=0.02), and ejection fraction from 14.7+/-6.4 to 21.0+/-8.6 (P=0.014). Meanwhile improvement of cardiac index, pulmonary wedge pressure and end-organ perfusion markers did not reach statistical significance. Three patients were successfully weaned off the balloon and recovered without additional interventions, two patients were transplanted and three were supported with counterpulsation until the implantation of assist device. Three patients died due to progressive heart failure, two after IABP removal and one after VAD implantation. There was no incidence of infection, limb ischemia, thrombus, or embolic complications. CONCLUSIONS: Our data showed that intra-aortic balloon pump support may be successfully and safely used in the acute decompensated dilated cardiomyopathypatients, as an urgent measure of cardiac support, to stabilize the patient and maintain organ perfusion until transplant is available, VAD is placed or patient is weaned from IABP.
Authors: Corstiaan A den Uil; Giorgia Galli; Lucia S Jewbali; Kadir Caliskan; Olivier C Manintveld; Jasper J Brugts; Nicolas M van Mieghem; Mattie J Lenzen; Eric Boersma; Alina A Constantinescu Journal: Cardiology Date: 2017-05-13 Impact factor: 1.869
Authors: Anthony W Castleberry; Adam D DeVore; Kevin W Southerland; James M Meza; William D Irish; Joseph G Rogers; Carmelo A Milano; Chetan B Patel Journal: ASAIO J Date: 2016 May-Jun Impact factor: 2.872
Authors: Brian A Bruckner; Leon P Jacob; Igor D Gregoric; Pranav Loyalka; Biswajit Kar; William E Cohn; Saverio La Francesca; Branislav Radovancevic; O H Frazier Journal: Tex Heart Inst J Date: 2008
Authors: Ju Hee Lee; Min Seok Kim; Byung Su Yoo; Sung Ji Park; Jin Joo Park; Mi Seung Shin; Jong Chan Youn; Sang Eun Lee; Se Yong Jang; Seonghoon Choi; Hyun Jai Cho; Seok Min Kang; Dong Ju Choi Journal: Korean Circ J Date: 2019-01 Impact factor: 3.243
Authors: Nuccia Morici; Giovanna Viola; Laura Antolini; Gianfranco Alicandro; Michela Dal Martello; Alice Sacco; Maurizio Bottiroli; Federico Pappalardo; Luca Villanova; Laura De Ponti; Carlo La Vecchia; Maria Frigerio; Fabrizio Oliva; Justin Fried; Paolo Colombo; Arthur Reshad Garan Journal: Int J Cardiol Heart Vasc Date: 2021-06-04
Authors: Jesse R Kimman; Nicolas M Van Mieghem; Henrik Endeman; Jasper J Brugts; Alina A Constantinescu; Olivier C Manintveld; Eric A Dubois; Corstiaan A den Uil Journal: Curr Heart Fail Rep Date: 2020-10