Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump

Roberto Lorusso; Samuel Heuts; Federica Jiritano; Roberto Scrofani; Carlo Antona; Guglielmo Actis Dato; Paolo Centofanti; Sandro Ferrarese; Matteo Matteuci; Antonio Miceli; Mattia Glauber; Enrico Vizzardi; Sandro Sponga; Igor Vendramin; Andrea Garatti; Carlo de Vincentis; Michele De Bonis; Silvia Ajello; Giovanni Troise; Margherita Dalla Tomba; Filiberto Serraino

doi:10.1093/icvts/ivac091

Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump

Roberto Lorusso^*, Samuel Heuts, Federica Jiritano, Roberto Scrofani, Carlo Antona, Guglielmo Actis Dato, Paolo Centofanti, Sandro Ferrarese, Matteo Matteuci, Antonio Miceli, Mattia Glauber, Enrico Vizzardi, Sandro Sponga, Igor Vendramin, Andrea Garatti, Carlo de Vincentis, Michele De Bonis, Silvia Ajello, Giovanni Troise, Margherita Dalla TombaFiliberto Serraino

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: Although the intra-aortic balloon pump (IABP) has been the most widely adopted temporary mechanical support device in cardiac surgical patients, its use has declined. The current study aimed to evaluate the occurrence and predictors of early mortality and complication rates in contemporary cardiac surgery patients supported by an IABP.

METHODS: A multicentre, retrospective analysis was performed of all consecutive cardiac surgical patients receiving perioperative balloon pump support in 8 centres between January 2010 to December 2019. The primary outcome was early mortality, and secondary outcomes were balloon-associated complications. A multivariable binary logistic regression model was applied to evaluate predictors of the primary outcome.

RESULTS: The study cohort consisted of 2615 consecutive patients. The median age was 68 years [25th percentile 61, 75th percentile 75 years], with the majority being male (76.9%), and a mean calculated 30-day mortality risk of 10.0%. Early mortality was 12.7% (n = 333), due to cardiac causes (n = 266), neurological causes (=22), balloon-related causes (n = 5) and other causes (n = 40). A composite end point of all vascular complications occurred in 7.2% of patients, and leg ischaemia was observed in 1.3% of patients. The most important predictors of early mortality were peripheral vascular disease [odds ratio (OR) 1.63], postoperative dialysis requirement (OR 10.40) and vascular complications (OR 2.57).

CONCLUSIONS: The use of the perioperative IABP proved to be safe and demonstrated relatively low complication rates, particularly for leg ischaemia. As such, we believe that specialists should not be held back to use this widely available treatment in high-risk cardiac surgical patients when indicated.

Original language	English
Number of pages	7
Journal	Interactive Cardiovascular and Thoracic Surgery
Volume	35
Issue number	1
Early online date	5 Apr 2022
DOIs	https://doi.org/10.1093/icvts/ivac091
Publication status	Published - 15 Jun 2022

Keywords

COUNTER-PULSATION
COUNTERPULSATION
Cardiac surgery
EFFICACY
GUIDELINES
Intra-aortic balloon pump
Mechanical circulatory support
Postcardiomy shock
VASCULAR COMPLICATIONS

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10.1093/icvts/ivac091Licence: CC BY-NC

Cite this

Lorusso, R., Heuts, S., Jiritano, F., Scrofani, R., Antona, C., Actis Dato, G., Centofanti, P., Ferrarese, S., Matteuci, M., Miceli, A., Glauber, M., Vizzardi, E., Sponga, S., Vendramin, I., Garatti, A., de Vincentis, C., De Bonis, M., Ajello, S., Troise, G., ... Serraino, F. (2022). Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump. Interactive Cardiovascular and Thoracic Surgery, 35(1). https://doi.org/10.1093/icvts/ivac091

@article{c7c2e84977fc47868cf18091c20c4bcb,

title = "Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump",

abstract = "OBJECTIVES: Although the intra-aortic balloon pump (IABP) has been the most widely adopted temporary mechanical support device in cardiac surgical patients, its use has declined. The current study aimed to evaluate the occurrence and predictors of early mortality and complication rates in contemporary cardiac surgery patients supported by an IABP.METHODS: A multicentre, retrospective analysis was performed of all consecutive cardiac surgical patients receiving perioperative balloon pump support in 8 centres between January 2010 to December 2019. The primary outcome was early mortality, and secondary outcomes were balloon-associated complications. A multivariable binary logistic regression model was applied to evaluate predictors of the primary outcome.RESULTS: The study cohort consisted of 2615 consecutive patients. The median age was 68 years [25th percentile 61, 75th percentile 75 years], with the majority being male (76.9%), and a mean calculated 30-day mortality risk of 10.0%. Early mortality was 12.7% (n = 333), due to cardiac causes (n = 266), neurological causes (=22), balloon-related causes (n = 5) and other causes (n = 40). A composite end point of all vascular complications occurred in 7.2% of patients, and leg ischaemia was observed in 1.3% of patients. The most important predictors of early mortality were peripheral vascular disease [odds ratio (OR) 1.63], postoperative dialysis requirement (OR 10.40) and vascular complications (OR 2.57).CONCLUSIONS: The use of the perioperative IABP proved to be safe and demonstrated relatively low complication rates, particularly for leg ischaemia. As such, we believe that specialists should not be held back to use this widely available treatment in high-risk cardiac surgical patients when indicated.",

keywords = "COUNTER-PULSATION, COUNTERPULSATION, Cardiac surgery, EFFICACY, GUIDELINES, Intra-aortic balloon pump, Mechanical circulatory support, Postcardiomy shock, VASCULAR COMPLICATIONS",

author = "Roberto Lorusso and Samuel Heuts and Federica Jiritano and Roberto Scrofani and Carlo Antona and {Actis Dato}, Guglielmo and Paolo Centofanti and Sandro Ferrarese and Matteo Matteuci and Antonio Miceli and Mattia Glauber and Enrico Vizzardi and Sandro Sponga and Igor Vendramin and Andrea Garatti and {de Vincentis}, Carlo and {De Bonis}, Michele and Silvia Ajello and Giovanni Troise and {Dalla Tomba}, Margherita and Filiberto Serraino",

note = "{\textcopyright} The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.",

year = "2022",

month = jun,

day = "15",

doi = "10.1093/icvts/ivac091",

language = "English",

volume = "35",

journal = "Interactive Cardiovascular and Thoracic Surgery",

issn = "1569-9293",

publisher = "Oxford University Press",

number = "1",

}

Lorusso, R , Heuts, S, Jiritano, F, Scrofani, R, Antona, C, Actis Dato, G, Centofanti, P, Ferrarese, S, Matteuci, M, Miceli, A, Glauber, M, Vizzardi, E, Sponga, S, Vendramin, I, Garatti, A, de Vincentis, C, De Bonis, M, Ajello, S, Troise, G, Dalla Tomba, M & Serraino, F 2022, 'Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump', Interactive Cardiovascular and Thoracic Surgery, vol. 35, no. 1. https://doi.org/10.1093/icvts/ivac091

TY - JOUR

T1 - Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump

AU - Lorusso, Roberto

AU - Heuts, Samuel

AU - Jiritano, Federica

AU - Scrofani, Roberto

AU - Antona, Carlo

AU - Actis Dato, Guglielmo

AU - Centofanti, Paolo

AU - Ferrarese, Sandro

AU - Matteuci, Matteo

AU - Miceli, Antonio

AU - Glauber, Mattia

AU - Vizzardi, Enrico

AU - Sponga, Sandro

AU - Vendramin, Igor

AU - Garatti, Andrea

AU - de Vincentis, Carlo

AU - De Bonis, Michele

AU - Ajello, Silvia

AU - Troise, Giovanni

AU - Dalla Tomba, Margherita

AU - Serraino, Filiberto

N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

PY - 2022/6/15

Y1 - 2022/6/15

N2 - OBJECTIVES: Although the intra-aortic balloon pump (IABP) has been the most widely adopted temporary mechanical support device in cardiac surgical patients, its use has declined. The current study aimed to evaluate the occurrence and predictors of early mortality and complication rates in contemporary cardiac surgery patients supported by an IABP.METHODS: A multicentre, retrospective analysis was performed of all consecutive cardiac surgical patients receiving perioperative balloon pump support in 8 centres between January 2010 to December 2019. The primary outcome was early mortality, and secondary outcomes were balloon-associated complications. A multivariable binary logistic regression model was applied to evaluate predictors of the primary outcome.RESULTS: The study cohort consisted of 2615 consecutive patients. The median age was 68 years [25th percentile 61, 75th percentile 75 years], with the majority being male (76.9%), and a mean calculated 30-day mortality risk of 10.0%. Early mortality was 12.7% (n = 333), due to cardiac causes (n = 266), neurological causes (=22), balloon-related causes (n = 5) and other causes (n = 40). A composite end point of all vascular complications occurred in 7.2% of patients, and leg ischaemia was observed in 1.3% of patients. The most important predictors of early mortality were peripheral vascular disease [odds ratio (OR) 1.63], postoperative dialysis requirement (OR 10.40) and vascular complications (OR 2.57).CONCLUSIONS: The use of the perioperative IABP proved to be safe and demonstrated relatively low complication rates, particularly for leg ischaemia. As such, we believe that specialists should not be held back to use this widely available treatment in high-risk cardiac surgical patients when indicated.

AB - OBJECTIVES: Although the intra-aortic balloon pump (IABP) has been the most widely adopted temporary mechanical support device in cardiac surgical patients, its use has declined. The current study aimed to evaluate the occurrence and predictors of early mortality and complication rates in contemporary cardiac surgery patients supported by an IABP.METHODS: A multicentre, retrospective analysis was performed of all consecutive cardiac surgical patients receiving perioperative balloon pump support in 8 centres between January 2010 to December 2019. The primary outcome was early mortality, and secondary outcomes were balloon-associated complications. A multivariable binary logistic regression model was applied to evaluate predictors of the primary outcome.RESULTS: The study cohort consisted of 2615 consecutive patients. The median age was 68 years [25th percentile 61, 75th percentile 75 years], with the majority being male (76.9%), and a mean calculated 30-day mortality risk of 10.0%. Early mortality was 12.7% (n = 333), due to cardiac causes (n = 266), neurological causes (=22), balloon-related causes (n = 5) and other causes (n = 40). A composite end point of all vascular complications occurred in 7.2% of patients, and leg ischaemia was observed in 1.3% of patients. The most important predictors of early mortality were peripheral vascular disease [odds ratio (OR) 1.63], postoperative dialysis requirement (OR 10.40) and vascular complications (OR 2.57).CONCLUSIONS: The use of the perioperative IABP proved to be safe and demonstrated relatively low complication rates, particularly for leg ischaemia. As such, we believe that specialists should not be held back to use this widely available treatment in high-risk cardiac surgical patients when indicated.

KW - COUNTER-PULSATION

KW - COUNTERPULSATION

KW - Cardiac surgery

KW - EFFICACY

KW - GUIDELINES

KW - Intra-aortic balloon pump

KW - Mechanical circulatory support

KW - Postcardiomy shock

KW - VASCULAR COMPLICATIONS

U2 - 10.1093/icvts/ivac091

DO - 10.1093/icvts/ivac091

M3 - Article

C2 - 35381083

SN - 1569-9293

VL - 35

JO - Interactive Cardiovascular and Thoracic Surgery

JF - Interactive Cardiovascular and Thoracic Surgery

IS - 1

ER -