Open AccessPreoperative Intra-aortic Balloon Support in Surgery for Left Main Coronary Stenosis
Author(s) -
George Cooper,
Arun K. Singh,
Frederic C. Christian,
C. W. Cashman,
Lester L. Vargas,
Karl E. Karlson
Publication year - 1977
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197702000-00020
Subject(s) - medicine , cardiopulmonary bypass , perioperative , stenosis , balloon , cardiology , intra aortic balloon pump , myocardial infarction , surgery , revascularization , balloon catheter , intra aortic balloon pumping , cardiogenic shock
Twenty-six patients with left main coronary (LMC) stenosis were operated upon with preoperative intra aortic balloon pump (IABP) support. There was no mortality, and no morbidity attributable to the balloon catheter. The most delicate facet of revascularization surgery in this entity is the pre-cardiopulmonary bypass phase including anesthesia induction during which blood pressure fluctuation may further diminish severely compromised coronary flow. Although systolic pressure dropped to below 100 mm Hg in 50% of patients during induction, there were only two patients with electrocardiographic evidence of perioperative myocardial infarction, and only one who needed rantic institution of cardiopulmonary bypass just after induction. Perioperative logistics were quite trouble free in all 26 patients, in marked contrast to 5 LMC patients operated upon prior to our preoperative IABP concent; 3 of these deteriorated upon induction, with two deaths resulting. Preoperative IABP is a reasonable supportive adjunct in surgery for LMC stenosis.