Implications for the vascular surgeon with prolonged (3 to 89 days) intraaortic balloon pump counterpulsation

Manord, J. D., Garrard, C. L., Mehra, M. R., Sternbergh, W. C., Ballinger, B., Ventura, H. O., Stapleton, D. D., Smart, F. W., Bowen, J. C. and Money, S. R. (1997). Implications for the vascular surgeon with prolonged (3 to 89 days) intraaortic balloon pump counterpulsation. In: 21st Annual Meeting of the Southern-Association-for-Vascular-Surgery, Coronado, CA, United States, (511-515). 22-25 January 1997. doi:10.1016/S0741-5214(97)70044-2


Author Manord, J. D.
Garrard, C. L.
Mehra, M. R.
Sternbergh, W. C.
Ballinger, B.
Ventura, H. O.
Stapleton, D. D.
Smart, F. W.
Bowen, J. C.
Money, S. R.
Title of paper Implications for the vascular surgeon with prolonged (3 to 89 days) intraaortic balloon pump counterpulsation
Conference name 21st Annual Meeting of the Southern-Association-for-Vascular-Surgery
Conference location Coronado, CA, United States
Conference dates 22-25 January 1997
Journal name Journal of Vascular Surgery   Check publisher's open access policy
Place of Publication Philadelphia, PA, United States
Publisher Mosby
Publication Year 1997
Sub-type Fully published paper
DOI 10.1016/S0741-5214(97)70044-2
ISSN 0741-5214
Volume 26
Issue 3
Start page 511
End page 515
Total pages 4
Language eng
Formatted Abstract/Summary
Purpose: The intraaortic balloon pump (IABP) is useful in the treatment of failing hearts. Although most experience with IABPs has been with acute short-term use, the safe duration of therapy and possible complications of long-term IABP use are uncertain. We evaluated the feasibility, management, and complications associated with long-term IABP therapy.

Methods: Fifty consecutive patients with 87 IABPs were evaluated retrospectively. All patients had IABP support for greater than 72 hours. Results and complications were evaluated.

Results: The mean duration of IABP support was 23.2 days. There were 21 IABP-related complications in 16 patients: (16 ischemic, three infections, two hemorrhage). The rate of complications was 0.13 per patient-week of support. Significant predictors of complications were total days of IABP support (p < 0.0001), use of multiple IABPs (p < 0.0001), and attempted but unsuccessful percutaneous insertions (p < 0.001). Complications led to 14 vascular procedures (five patch angioplasties, four bypass procedures, two major amputations, one fasciotomy, one groin exploration for hemorrhage, and one removal of an infected Dacron patch). Percutaneous removals had a 14% complication rate compared with none after operative removal (p = 0.02). Thirty-two patients survived (64%). Of the survivors, 27 underwent transplant.

Conclusions: Prolonged IABP therapy is feasible and is associated with an acceptable rate of complications. Operative removal is superior to percutaneous removal. Percutaneous removal should be limited to short-term therapy. There is no need for mandatory removal or site rotation based solely on indwelling time.
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 20:02:30 EST