BACKGROUND: The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its cost-effectiveness. METHODS: Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ejection fraction of 0.25 or less underwent isolated coronary artery bypass grafting. An intraaortic balloon pump was inserted before operation in 37 patients (group A). The remaining 126 patients underwent operation without preoperative insertion of the device (group B). Preoperatively, 91.9% (34/37) of group A patients and 54.8% (69/126) of group B patients were in New York Heart Association functional class III or IV (p < 0.001). RESULTS: The 30-day mortality rate was 2.7% (1/37) and 11.9% (15/126) for groups A and B, respectively (p < 0.005). All deaths occurred in patients in functional class III or IV. In group B, 28 patients (22.2%) required an intraaortic balloon pump after cardiotomy for low cardiac output, 42.9% (12/28) of whom died. Median postoperative hospital stay was 9.9 days and 12.0 days, and mean hospital charges were $50,627 and $54,818 for survivors in groups A and B; respectively (p = not significant). CONCLUSIONS: Our experience suggests that patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting may benefit from preoperative intraaortic balloon pump insertion, especially patients in functional class III or IV. This approach improved survival significantly, reduced hospital stay, and was more cost-effective.
BACKGROUND: The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its cost-effectiveness. METHODS: Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ejection fraction of 0.25 or less underwent isolated coronary artery bypass grafting. An intraaortic balloon pump was inserted before operation in 37 patients (group A). The remaining 126 patients underwent operation without preoperative insertion of the device (group B). Preoperatively, 91.9% (34/37) of group A patients and 54.8% (69/126) of group B patients were in New York Heart Association functional class III or IV (p < 0.001). RESULTS: The 30-day mortality rate was 2.7% (1/37) and 11.9% (15/126) for groups A and B, respectively (p < 0.005). All deaths occurred in patients in functional class III or IV. In group B, 28 patients (22.2%) required an intraaortic balloon pump after cardiotomy for low cardiac output, 42.9% (12/28) of whom died. Median postoperative hospital stay was 9.9 days and 12.0 days, and mean hospital charges were $50,627 and $54,818 for survivors in groups A and B; respectively (p = not significant). CONCLUSIONS: Our experience suggests that patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting may benefit from preoperative intraaortic balloon pump insertion, especially patients in functional class III or IV. This approach improved survival significantly, reduced hospital stay, and was more cost-effective.
Authors: Antonio Miceli; Simon M J Duggan; Radek Capoun; Francesco Romeo; Massimo Caputo; Gianni D Angelini Journal: Ann Thorac Surg Date: 2010-08 Impact factor: 4.330
Authors: Thomas Theologou; Mohamad Bashir; Arvind Rengarajan; Omar Khan; Tom Spyt; David Richens; Mark Field Journal: Cochrane Database Syst Rev Date: 2011-01-19
Authors: André L Hovnanian; Alexandre de Matos Soeiro; Carlos Vicente Serrano; Sérgio Almeida de Oliveira; Fábio B Jatene; Noedir A G Stolf; José A F Ramires Journal: Clinics (Sao Paulo) Date: 2010 Impact factor: 2.365
Authors: Yücel Özen; Mehmet Aksut; Davut Cekmecelioglu; Mehmet Dedemoglu; Ozge Altas; Sabit Sarikaya; Murat Bulent Rabus; Kaan Kirali Journal: J Cardiovasc Thorac Res Date: 2018-09-24