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European Heart Journal 1980 1(1):31-43;
Copyright © 1980 by the European Society of Cardiology.
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© 1980 The European Society of Cardiology

Intra aortic ballon pumping in myocardial infarction and unstable angina

R. MICHELS, M. HAALEBOS, P.-P. KINT, F. HAGEMEIJER, K. BALAKUMARAN, M. VAN DER BRAND, P. W. SERRUYS and P. G. HUGENHOLTZ

University Hospital Dijkzigt, Thoraxcenter P.O. Box 1738, Rotterdam, The Netherlands

Received 1 July 1979; .

From 1972 to 1979 intra aortic balloon pumping (IABP) was attempted in 181 patients; catheter insertion failed in 13 (8%). More complications occurred with prolonged treatment but all three lethal complications (2%) were related to catheter insertion.

Seventy-six patients had clinical cardiogenic shock after myocardial infarction (CSMI). Haemodynamically, 23 were classified as preshock: 15 (66%) could be weaned, 12 (53%) survived over 3 months; whereas only 27/51 patients (51%) haemodynamically classified as shock could be weaned and 21 (40%) survived over 3 months.

Of forty-two patients with refractory angina at rest, 41 had prompt relief of pain after IABP, and subsequently underwent coronary artery bypasss grafting (CABG). Perioperative infarction rate was 8% (4/41), perioperative mortality was 7% (3/41). Total infarction rate was 11% (5/42), and total mortality 7% (3/41).

Pain relief was prompt in 14/17 patients (82%) with refractory angina after infarction. Pain persisted in three patients: all three sustained an infarction, one died. Two patients were excluded from surgery. Twelve patients underwent CABG; none died, none developed MI.

In eight patients persistence of pain suggested a slowly evolving MI, IABP abolished pain in seven.

Conclusion: IABP has demonstrated its efficacy both in pump failure and in refractory ischaemia. However, its use is not without risks.

Key Words: Balloon pumping • cardiogenic shock


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