Document Detail

Elective intraaortic balloon counterpulsation in high-risk off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  16426339     Owner:  NLM     Status:  MEDLINE    
The beneficial effects of intraaortic balloon pump (IABP) in CABG with cardiopulmonary bypass (CPB) have been reported. However, the benefits of insertion of IABP electively in high-risk off-pump coronary artery bypass grafting (OPCAB) have not been established. Six hundred and twenty-five patients who underwent OPCAB form the study group. High-risk patients fulfilling two or more of the following: left main stem stenosis >70%, unstable angina, and poor left ventricular function, who had elective insertion of IABP preoperatively by the open technique (group I; n = 20) were compared with a similar high-risk group that did not (group II; n = 25). There were no significant differences in risk factors between the two groups (Euroscore 5.68). The mean number of grafts was similar. Postoperatively, there were no significant differences in the need for inotropes, duration of ventilation, arrhythmias, cerebrovascular, gastrointestinal, and infective complications (p = NS). There were no IABP-related complications. Acute renal failure requiring hemofiltration was higher in group II (n = 5; p < 0.05). Four patients (16%) in group II required postoperative IABP. Although intensive care stay was longer in group I (27.6 +/- 15.3 vs. 18.6 +/- 9.1 hours; p < 0.05), patients in group I were discharged earlier from hospital. There was no difference in mortality between the two groups (n = 1 in each group). In high-risk patients undergoing OPCAB, routine preoperative insertion of IABP electively reduces the incidence of acute renal failure. In addition it avoids the need for emergency insertion postoperatively and may result in earlier discharge.
Hunaid A Vohra; Wadih R Dimitri
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  21     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2006 Jan-Feb
Date Detail:
Created Date:  2006-01-23     Completed Date:  2006-05-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-5     Citation Subset:  IM    
Department of Cardiothoracic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Coventry, United Kingdom.
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MeSH Terms
Coronary Artery Bypass, Off-Pump / methods*
Follow-Up Studies
Intra-Aortic Balloon Pumping*
Kidney Failure, Acute / etiology,  prevention & control
Middle Aged
Myocardial Contraction
Myocardial Ischemia / complications,  physiopathology,  surgery*
Retrospective Studies
Risk Factors
Treatment Outcome
Ventricular Dysfunction, Left / complications,  physiopathology,  surgery*

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