TY - JOUR
T1 - Trends in intraaortic balloon counterpulsation complications and outcomes in cardiac surgery
AU - Christenson, Jan T.
AU - Cohen, Marc
AU - Ferguson, James J.
AU - Freedman, Robert J.
AU - Miller, Michael F.
AU - Ohman, E. Magnus
AU - Reddy, Ramachandra C.
AU - Stone, Gregg W.
AU - Urban, Philip M.
N1 - Funding Information:
The benchmark registry was supported by a grant from Datascope Corporation. In addition, the authors would like to thank Debra Joseph from Datascope Corporation for her help with the benchmark registry.
PY - 2002/10/1
Y1 - 2002/10/1
N2 - Background. As the proportion of high-risk patients for cardiac surgery increases, use of intraaortic balloon counterpulsation (IABC) has increased, especially in preoperative therapy. Although the efficacy and cost-effectiveness of IABC have been demonstrated, historically higher complication rates have dissuaded some practitioners from using IABC. Methods. This report describes IABC use in cardiac surgery, examines trends in complications over time, and compares outcomes in preoperative versus postoperative use in a single prospective worldwide registry over the past 3 years. Results. The frequency of IABC use appears to be increasing with time as the complication rates have dramatically fallen. The overall IABC-related complication rate was 6.5% (460/7,101), and the rate of major complications (requiring surgery or transfusion) was 2.1% (148/7,101). Hospital mortality was significantly lower in patients treated preoperatively with IABC compared with patients treated postoperatively (8.8% vs 28.2%, p < 0.0001), although this may be due to a selection bias in the postoperative group. Conclusions. Preoperative IABC therapy leads to better patient outcomes in high-risk CABG patients. Improved IABC technology and better surveillance have led to increased use with lower complication rates. Although selection bias is inherent in retrospective studies, the Benchmark Counterpulsation Outcomes Registry outcomes are in close concordance to prospective randomized studies previously reported.
AB - Background. As the proportion of high-risk patients for cardiac surgery increases, use of intraaortic balloon counterpulsation (IABC) has increased, especially in preoperative therapy. Although the efficacy and cost-effectiveness of IABC have been demonstrated, historically higher complication rates have dissuaded some practitioners from using IABC. Methods. This report describes IABC use in cardiac surgery, examines trends in complications over time, and compares outcomes in preoperative versus postoperative use in a single prospective worldwide registry over the past 3 years. Results. The frequency of IABC use appears to be increasing with time as the complication rates have dramatically fallen. The overall IABC-related complication rate was 6.5% (460/7,101), and the rate of major complications (requiring surgery or transfusion) was 2.1% (148/7,101). Hospital mortality was significantly lower in patients treated preoperatively with IABC compared with patients treated postoperatively (8.8% vs 28.2%, p < 0.0001), although this may be due to a selection bias in the postoperative group. Conclusions. Preoperative IABC therapy leads to better patient outcomes in high-risk CABG patients. Improved IABC technology and better surveillance have led to increased use with lower complication rates. Although selection bias is inherent in retrospective studies, the Benchmark Counterpulsation Outcomes Registry outcomes are in close concordance to prospective randomized studies previously reported.
UR - http://www.scopus.com/inward/record.url?scp=0036797868&partnerID=8YFLogxK
U2 - 10.1016/S0003-4975(02)03854-7
DO - 10.1016/S0003-4975(02)03854-7
M3 - Article
C2 - 12400750
AN - SCOPUS:0036797868
SN - 0003-4975
VL - 74
SP - 1086
EP - 1090
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 4
ER -