LEFT VENTRICULAR ASSIST
The current practice of intra-aortic balloon counterpulsation: results from the Benchmark Registry
James J. Ferguson, III, MD, FACC*,*,
Marc Cohen, MD, FACC ,
Robert J. Freedman, Jr, MD, FACC ,
Gregg W. Stone, MD, FACC ,
Michael F. Miller, PhD||,
Debra L. Joseph, BSN¶ and
E. Magnus Ohman, MD, FACC#
* Texas Heart Institute, Houston, Texas, USA
Hahnemann University Hospital, Philadelphia, Pennsylvania, USA
Tulane University Medical Center, New Orleans, Louisiana, USA
Cardiology Research Foundation, Washington, DC, USA
|| M. F. Miller Statistical Services, Langhorne, Pennsylvania, USA
¶ Datascope Corp., Fairfield, New Jersey, USA
# University of North Carolina, Chapel Hill, North Carolina, USA
Manuscript received May 22, 2001;
accepted July 23, 2001.
* Reprint requests and correspondence to: Dr. James J. Ferguson III, Texas Heart Institute Cardiology Research, MC1-191, 1101 Bates Street, Houston, Texas 77030 USA
jferguson{at}heart.thi.tmc.edu
OBJECTIVES
This study presents clinical data from the first large registry of aortic counterpulsation, a computerized database that incorporates prospectively gathered data on indications for intra-aortic balloon counterpulsation (IABP) use, patient demographics, concomitant medication and in-hospital outcomes and complications.
BACKGROUND
The intra-aortic balloon pump (IABP) is widely used to provide circulatory support for patients experiencing hemodynamic instability due to myocardial infarction, cardiogenic shock, or in very high risk patients undergoing angioplasty or coronary artery bypass grafting.
METHODS
Between June 1996 and August 2000, 203 hospitals worldwide (90% U.S., 10% non-U.S.) collected 16,909 patient case records (68.8% men, 31.2% women; mean age 65.9 ± 11.7 years).
RESULTS
The most frequent indications for use of IABP were as follows: to provide hemodynamic support during or after cardiac catheterization (20.6%), cardiogenic shock (18.8%), weaning from cardiopulmonary bypass (16.1%), preoperative use in high risk patients (13.0%) and refractory unstable angina (12.3%). Major IABP complications (major limb ischemia, severe bleeding, balloon leak, death directly due to IABP insertion or failure) occurred in 2.6% of cases; in-hospital mortality was 21.2% (11.6% with the balloon in place). Female gender, high age and peripheral vascular disease were independent predictors of a serious complication.
CONCLUSIONS
This registry provides a useful tool for monitoring the evolving practice of IABP. In the modern-day practice of IABP, complication rates are generally low, although in-hospital mortality remains high. There is an increased risk of major complications in women, older patients and patients with peripheral vascular disease.
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Abbreviations and Acronyms
| | AMI | = acute myocardial infarction | | BSA | = body surface area | | CABG | = coronary artery bypass graft | | IAB | = intra-aortic balloon | | IABP | = intra-aortic balloon pump | | LOS | = length of stay | | PVD | = peripheral vascular disease |
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|
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|
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|
|
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|
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|
|
|
|
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|
|
|
|
|
|
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|
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|
|
|
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|
|
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