Does IABP insertion before bypass surgery in patients with severe left ventricular dysfunction improves prognosis?

Introduction:

Intra aortic balloon counterpulsation (IABP) is a method of temporary mechanical circulatory support that attempts to create more favorable balance of myocardial oxygen supply and demand by using the concept of systolic unloading and diastolic augmentation. We aimed to examine and evaluate the effect of IABP in patients with poor cardiac function scheduled for bypass surgery.

Material and methods:

The IABP group data base, which included 5 patients during 2019 was used. Clinical, echocardiographic and laboratory data of all patients who were connected to IABP 1-24 hours before bypass surgery were compared to 6 patients with severe left ventricular systolic dysfunction who underwent bypass surgery at that time.

Results and discussion:

Average ICU hospitalization days was similar in both groups (3.6),however the total hospitalization stay was longer in IABP group, averaging at 12.5 days,compared to 9.1 days in the other group. The ejection fraction (20-30%) was the same in both groups. A lower troponin levelwas observed in the IABP group (5090 vs 12100). The average bypass time was longer in the IABP group, 136 vs 111 min. One death was registered in the IABP group vrs none in the other group.

Conclusion:

Against all expectations, IABP insertion before bypass surgery in patients with severely reduced systolic left ventricular function does not shorten ICU hospitalization days and does not affect the clinical status and did not improve prognosis.