Application of Intra-aortic Balloon Pump in Patients with Mild or Mild to Moderate Aortic Regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Hao , DING Fangbao , HUANG Jianbing

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, P. R. China;

Corresponding author：

Keywords：

Intra-aortic balloon pump; Aortic regurgitation; Left ventricular ejection fraction; Cardiac index

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Abstract： Objective To estimate the effectiveness and safety of intra-aortic balloon pump （IABP）in the patients with mild or mild to moderate aortic regurgitation. Methods A total of 15 patients with mild or mild to moderate aortic regurgitation and low left ventricular ejection fraction (LVEF＜ 40.00%) including 11 males and 4 females, who underwent IABP application after cardiac surgery between September 2006 and January 2011, were included in this study. Their age ranged from 50 to 74 years with an average age of 63.60 years. There were 9 patients with mild aortic regurgitation and 6 patients with mild to moderate aortic regurgitation, all with LVEF ＜ 40.00%. IABP catheters were inserted before operation and IABP worked after heart the recovery of heart beat. Mean aortic pressure (MAP), cardiac index (CI), systemic vascular resistance index (SVRI), pulmonary vascular resistance index (PVRI), LVEF , and aortic regurgitation volume before the use of IABP and after stopping use of it were compared. Results The total mortality was zero. The patients’ CI significantly improved from 1.99±0.23 L/(min.m2) to 3.30±0.29 L/(min.m2) after IABP （t =48.30，P=0.00）. Their LVEFs were significantly improved after use of IABP (37.20%±1.37% versus 42.60%±2.87%， t =11.34，P=0.00）. Their SVRI improved significantly (2 347.00±190.00 dyn·s/(cm5·m2) versus 2 128.00±204.00 dyn·s/(cm5 · m2)，t=20.60, P=0.00）after use of IABP. However, their aortic regurgitation volume were not significantly increased（χ2=0.60, P=0.44）. Conclusion Application of IABP in patients with mild or mild to moderate aortic regurgitation and low LVEF can obtain good circulation support after operation without increasing their aortic regurgitation.

Citation： LIU Hao,DING Fangbao,HUANG Jianbing,et al .. Application of Intra-aortic Balloon Pump in Patients with Mild or Mild to Moderate Aortic Regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(1): 48-51. doi: Copy

1.	Laird JD, Madras PN, Jones RT, et al. Theoretical and experimental analysis of the intra-aortic balloon pump. Trans Am Soc Artif Intern Organs, 1968, 14：338-343.
2.	Davidson J, Baumgariner F, Omari B, et al. Intra-aortic balloon pump：indications and complications. J Natl Med Assoc, 1998, 90(3)：137-140.
3.	Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery： summary article： a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to update the 1999 guidelines for coronary Arte. Circulation, 2004, 110(9)： 1168-1176.
4.	Allie DE, Lirtzman M, Malik AP, et al. Rapid-staged strategy for concomitant critical carotid and left main coronary disease with left ventricular dysfunction：IABP use. Ann Thorac Surg, 1998, 66 (4)：1230-1235.
5.	Miceli A, Duggan SM, Capoun R, et al. A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(2)：522-526.
6.	Ranucci M, Ballotta A, Castelvecchio S, et al. Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion. Acta Anaesthesiol Scand, 2010, 54(7)：878-884.
7.	Bonios MJ, Pierrakos CN, Argiriou M, et al. Increase in coronary blood flow by intra-aortic balloon counterpulsation in a porcine model of myocardial reperfusion. Int J Cardiol, 2010, 138(3)：253-260.
8.	Trost JC, Hillis LD. Intra-aortic balloon counterpulsation. Am J Cardiol, 2006, 97(9)：1391-1398.
9.	Albertus S. Intra-aortic balloon counterpulsation therapy. Crit Care Nurse, 2006, 26(1)：14.
10.	Santini F, Bertolini P, Rossi A, et al. Unexpected complication of intra-aortic balloon counterpulsation via the ascending aorta：balloon migration. Eur J Cardiothorac Surg, 1997, 11(3)：579-581.
11.	Meisel S, Shochat M, Sheikha SA, et al. Utilization of low-profile intra-aortic balloon catheters inserted by the sheathless technique in acute cardiac patients：clinical efficacy with a very low complication rate. Clin Cardiol, 2004, 27(11)：600-604.
12.	Van WD, Bennink GB, Benatar AA. Complication of intra-aortic balloon pumping in a pediatric patient. Eur J Cardiothorac Surg, 1995, 9(10)：602-603.
13.	Papaioannou TG, Christodoulos S. Basic principles of the intraaortic balloon pump and mechanisms affecting its performance. Asaio J, 2005, 51(3)：296-300.
14.	Elahi MM, Chetty GK, Kirke R, et al. Complications related to intra-aortic balloon pump in cardiac surgery：a decade later. Eur J Vasc Endovasc Surg, 2005, 29(6)：591-594.
15.	Roy SK, Howard EW, Panza JA, et al. Clinical implications of thrombocytopenia among patients undergoing intra-aortic balloon pump counterpulsation in the coronary care unit. Clin Cardiol, 2010, 33(1)：30-35.
16.	Bream-rouwenhorst HR, Hobbs RA, Horwitz PA. Thrombocytopenia in patients treated with heparin, combination antiplatelet therapy, and intra-aortic balloon pump counterpulsation. J Interv Cardiol, 2008, 21(4)：350-356.

1. 　Laird JD, Madras PN, Jones RT, et al. Theoretical and experimental analysis of the intra-aortic balloon pump. Trans Am Soc Artif Intern Organs, 1968, 14：338-343.
2. 　Davidson J, Baumgariner F, Omari B, et al. Intra-aortic balloon pump：indications and complications. J Natl Med Assoc, 1998, 90(3)：137-140.
3. 　Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery： summary article： a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to update the 1999 guidelines for coronary Arte. Circulation, 2004, 110(9)： 1168-1176.
4. 　Allie DE, Lirtzman M, Malik AP, et al. Rapid-staged strategy for concomitant critical carotid and left main coronary disease with left ventricular dysfunction：IABP use. Ann Thorac Surg, 1998, 66 (4)：1230-1235.
5. 　Miceli A, Duggan SM, Capoun R, et al. A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(2)：522-526.
6. 　Ranucci M, Ballotta A, Castelvecchio S, et al. Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion. Acta Anaesthesiol Scand, 2010, 54(7)：878-884.
7. 　Bonios MJ, Pierrakos CN, Argiriou M, et al. Increase in coronary blood flow by intra-aortic balloon counterpulsation in a porcine model of myocardial reperfusion. Int J Cardiol, 2010, 138(3)：253-260.
8. 　Trost JC, Hillis LD. Intra-aortic balloon counterpulsation. Am J Cardiol, 2006, 97(9)：1391-1398.
9. 　Albertus S. Intra-aortic balloon counterpulsation therapy. Crit Care Nurse, 2006, 26(1)：14.
10. 　Santini F, Bertolini P, Rossi A, et al. Unexpected complication of intra-aortic balloon counterpulsation via the ascending aorta：balloon migration. Eur J Cardiothorac Surg, 1997, 11(3)：579-581.
11. 　Meisel S, Shochat M, Sheikha SA, et al. Utilization of low-profile intra-aortic balloon catheters inserted by the sheathless technique in acute cardiac patients：clinical efficacy with a very low complication rate. Clin Cardiol, 2004, 27(11)：600-604.
12. 　Van WD, Bennink GB, Benatar AA. Complication of intra-aortic balloon pumping in a pediatric patient. Eur J Cardiothorac Surg, 1995, 9(10)：602-603.
13. 　Papaioannou TG, Christodoulos S. Basic principles of the intraaortic balloon pump and mechanisms affecting its performance. Asaio J, 2005, 51(3)：296-300.
14. 　Elahi MM, Chetty GK, Kirke R, et al. Complications related to intra-aortic balloon pump in cardiac surgery：a decade later. Eur J Vasc Endovasc Surg, 2005, 29(6)：591-594.
15. 　Roy SK, Howard EW, Panza JA, et al. Clinical implications of thrombocytopenia among patients undergoing intra-aortic balloon pump counterpulsation in the coronary care unit. Clin Cardiol, 2010, 33(1)：30-35.
16. 　Bream-rouwenhorst HR, Hobbs RA, Horwitz PA. Thrombocytopenia in patients treated with heparin, combination antiplatelet therapy, and intra-aortic balloon pump counterpulsation. J Interv Cardiol, 2008, 21(4)：350-356.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of Intra-aortic Balloon Pump in Patients with Mild or Mild to Moderate Aortic Regurgitation

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