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Early intra-aortic balloon pumping following perioperative myocardial injury improves hospital and mid-term prognosis

^a Cardiac Surgery Unit, University of Magna Graecia, Viale Europa, 88100, Catanzaro, Italy
^b Anesthesiology and Intensive Care Unit, University of Magna Graecia, Catanzaro, Italy

*Corresponding author. Tel.: +39-0961-3647033; fax: +39-0961-3697142.

E-mail address: antonio.rubino{at}hotmail.com (A.S. Rubino).

We evaluated the impact of immediate intra-aortic balloon pumping (IABP) on hospital and mid-term outcome of coronary artery bypass graft (CABG) whenever perioperative acute complications developed. We compared clinical, biochemical, echocardiographic in-hospital results and two-year follow-up outcome of 30 low-risk (EuroSCORE<5) CABG (group A) who immediately received perioperative IABP when acute complications were suspected, to a contemporary, uncomplicated case-matched group (30 patients; Group B). Two in-hospital deaths were recorded in group A with no deaths in controls (P=0.492). Group A showed significantly higher lactate only at ICU arrival (P=0.001). Troponin I was always higher, but never reached values diagnostic for myocardial infarction (P<0.001). Worse left ventricular ejection fraction (P<0.001) and wall motion score index (P=0.008) were recorded at ICU arrival in group A, although an almost complete recovery was registered at discharge. Two-year actuarial survival was similar between the two groups (P=0.598). No differences were observed in freedom from acute myocardial infarction (P=0.503) and from overall cardiac complications (P=0.410). Early IABP should be established whenever cardiac complications are suspected, because of its beneficial impact on enzymatic leakage, myocardial recovery at echocardiography, hospital outcome, mid-term follow-up survival and freedom from cardiovascular events.

Key Words: IABP; CABG; Cardiac complications