Background: The use of intraaortic balloon pump (IABP) effectively reduces left ventricular afterload and significantly increases coronary perfusion pressure by raising aortic diastolic pressure. This study examined the short and medium-term outcomes of 22,540 adult cardiac surgical patients requiring an IABP.
Methods: From 2009 to 2018, 1114 patients (4.94%) undergoing open-heart surgery at a single tertiary cardiac hospital received IABP support and were included in this retrospective study. They were categorized into pre-operative (Group A, n = 577), intra-operative (Group B, n = 475), and post-operative (Group C, n = 62) IABP insertion groups.
Results: Cardiogenic shock occurred in 11.2% of cases, mainly in Group A. Hemodynamic instability (38.8%) drove IABP use in Groups A and C, while difficulty weaning from CPB was the primary reason in Group C. The overall operative mortality rate was 10.9%, highest at 25.8% postoperatively. Multivariate analysis identified significant predictors of mortality: age (OR: 1.067, 95% CI: 1.041-1.094, p < 0.001), higher BMI (OR: 1.071, 95% CI: 1.017-1.128, p = 0.009), pulmonary hypertension (OR: 2.085, 95% CI: 1.302-3.341, p = 0.002), renal disease (OR: 2.780, 95% CI: 1.556-4.967, p < 0.001), and cardiogenic shock (OR: 3.684, 95% CI: 2.066-6.569, p < 0.001). Complications were more common in Group C, especially with renal disease. Average preoperative and postoperative stays were 4.0 ± 4.8 days and 15.2 ± 20.4 days, respectively, with no significant differences between groups.
Conclusion: IABP might offer safety for open-heart surgery, with longer hospital stays potentially associated with high-risk patients. Pre-operative IABP prophylaxis could be crucial in high-risk open-heart cases to reduce mortality.Clinical registration number: NHG DSRB Ref No# 2016/01070 and 2019/00397.
Keywords: Clinical outcomes; Complications; Hospital-stay; Intra-aortic balloon pump; Mortality; Open heart surgery.
