Document Detail


The impact of intraaortic balloon counterpulsation on bypass graft flow in patients with peripheral ECMO.
MedLine Citation:
PMID:  19438779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Numerous reports have been performed to investigate the hemodynamic effects of intraaortic balloon pumping (IABP) and nonpulsatile circulatory extracorporeal membrane oxygenation (ECMO), but studies on its impact on coronary artery bypass graft flow during concomitant use of IABP and ECMO are lacking. The aim of this study was to assess the impact of additional IABP support on the degree of blood flow increase in bypass grafts in high-risk patients with nonpulsatile femoral venoarterial ECMO. METHODS: In six emergency coronary artery bypass graft patients (mean age = 66.3 +/- 2.1 years, gender = five males and one female, ejection fraction = 25.0 +/- 3.0%) requiring mechanical circulatory support with ECMO hemodynamic parameters and bypass graft flows were measured with and without IABP counterpulsation. A transit time flowmeter was used for intraoperative graft flow and pulsatility index (PI) measurements. Patients provided their control values. RESULTS: The average value of the mean arterial pressure recorded prior to IABP was 63.6 + 2.9 mmHg and during IABP support 67.8 + 2.9 mmHg (p < 0.0001). IABP augmented the mean bypass graft flow from 46.8 +/- 9.6 mL/min to 56.4 +/- 12.1 mL/min (p < 0.005), resulting in a 17% increase. The difference in the PI was not statistically significant (2.6 +/- 0.2 with IABP, 2.6 +/- 0.3 without IABP). CONCLUSIONS: We conclude that IABP-induced pulsatility significantly improves coronary bypass graft flows during nonpulsatile peripheral ECMO.
Authors:
Navid Madershahian; Oliver J Liakopoulos; Jens Wippermann; Shahriar Salehi-Gilani; Thorsten Wittwer; Yeong-Hoon Choi; Hamid Naraghi; Thorsten Wahlers
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  24     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2009 May-Jun
Date Detail:
Created Date:  2009-05-14     Completed Date:  2009-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  265-8     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Cologne University Heart Centre, Cologne, Germany. navid.madershahian@web.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity / physiology*
Coronary Artery Bypass / methods*
Coronary Artery Disease / physiopathology,  surgery*
Equipment Design
Extracorporeal Membrane Oxygenation / instrumentation*
Female
Follow-Up Studies
Humans
Intra-Aortic Balloon Pumping / methods*
Male
Mammary Arteries / physiopathology*,  transplantation
Treatment Outcome

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


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