Document Detail


Clinical and hemodynamic results of intraortic balloon counterpulsation and surgery for cardiogenic shock.
MedLine Citation:
PMID:  300213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Forty-two patients with cardiogenic shock (CS) secondary to myocardial infarction were treated with intra-aortic balloon pumping (I.A.B.P.). In 14 patients C.S. was associated with ventricular septal defect (V.S.D.) and in four with mitral regurgitation (M.R.) secondary to rupture of the posterior papillary muscle. All patients were resistant to conventional medical therapy. Shock was reversed in 20 of the 24 patients in C.S. without mechanical complications. After 24 to 48 hours of I.A.B.P., cardiax index (C.I.) increased from 1.38 to 2.00 L./min./M2, systolic arterial pressure (S.A.P.) from 83 to 96 mm. Hg, urinary output (U.O.) from 10 to 56 ml. per hour, and pulmonary wedge pressure (P.W.P.) decreased from 22 to 16 mm. Hg. Three patients treated with I.A.B.P. alone survived more than 1 year; of the 13 patients who were balloon dependent, four have undergone emergency surgical procedures and two were long-term survivors. In all patients with mechanical complications, I.A.B.P. resulted in significant clinical and hemodynamic improvement. P.W.P. decreased from 19 to 15 mm. Hg, and U.O. increased from 13 to 38 ml. per hour while S.A.P. remained unchanged. In patients with V.S.D. the pulmonary/systemic flow ratio (P/S) declined from 3.5 to 2.8; in patients with M.R., "V" wave amplitude decreased by 8 mm. Hg. Emergency surgery was performed in 10 patients with V.S.D. and in three patients with M.R. and there were eight long-term survivors (13 to 27 months). It is concluded that I.A.B.P. is an effective means of supporting the circulation in C.S. Of the 42 patients with C.S. treated by combining I.A.B.P. and emergency surgery, 13(31%) were long-term survivors (20 +/- 6 months).
Authors:
J Bardet; C Masquet; J C Kahn; R Gourgon; J P Bourdarias; A Mathivat; Y Bouvrain
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  93     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1977 Mar 
Date Detail:
Created Date:  1977-04-15     Completed Date:  1977-04-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  280-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Assisted Circulation* / adverse effects
Blood Pressure
Cardiac Output
Coronary Angiography
Coronary Artery Bypass
Female
Heart Rate
Heart Septum / surgery
Hemodynamics*
Humans
Intra-Aortic Balloon Pumping* / adverse effects
Male
Middle Aged
Postoperative Complications / mortality
Rupture, Spontaneous / surgery
Shock, Cardiogenic / mortality,  surgery,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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