In the era of coronary artery bypass grafting, the intraaortic balloon pump (IABP) is more widely used and its indication has been expanded. We performed retrospective clinical analysis on the patients who have recived IABP pre and/or
postoperatively
during the course of CABG.
From January 1981 to June 1995, total 322 patients have received CABC at the Seoul National University Hospital and among them 50 patients(15.5%) were supported by IABP during the course of the operation. The mean age at the time of the operation
was
57.2 years(39~75 years) and the male to female ratio was 33 : 17. The preoperative diagnosis was unstable angina in 33(66%), stable angina in 7(14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13
cases(26%)
with left main disease, 13(26%) with class IV angina, 12(24%) with difficulty in CPB weaning, 6(12%) with difficulty in CPB weaning, 6(12%) with postinfarct angina and 3(6%) with severe LV dysfunction. In the remaining 3 cases, one patient was
operated
on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low cardiac output syndrome. All IABPs were introduced via femoral artery and among them 45 cases(90%) percutaneously. The mean
postoperative assist time was 22.3 hours(0.5~168 hours) and IABP could be removed within 48 hours in most of them(44/50). The operative mortality was 6.1%(3 cases) and postoperative morbidity was only one with lower extremity ischemia.
The more general application of the IABP during the course of the CABG, especially in patients with high preoperative risk factors or diffculty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.
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