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European Heart Journal 1987 8(5):490-502;
Copyright © 1987 by the European Society of Cardiology.
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© 1987 The European Society of Cardiology

Long-term survival after counterpulsation for medically refractory heart failure complicating myocardial infarction and cardiac surgery

D. L. Kuchar, T. J. Campbell and M. F. O'Rourke

Department of Medicine, University of New South Wales Sydney, Australia

Received 4 June 1986; revised 10 October 1986; .

Address for correspondence: Michael O'Rourke, MD, Medical Professorial Unit, St. Vincent's Hospital, Darlinghurst NSW 2010, Australia.

Abstract

Intra-aortic balloon counterpulsation (IABP) was performed in 225 patients over a 12-year period for the treatment of severe left ventricular failure following acute myocardial infarction and cardiac surgery, and which had failed to respond to conventional therapy. Of these patients, 97 (43%) were discharged alive from hospital. Patients were followed-up for a mean of 5.8 years (3 months to II years) and assessment of functional status was made. In patients with shock after myocardial infarction, the most favourable outcome was seen in patients who had mechanical cardiac defects which were corrected after institution of IABP and in those treated within 8 hours of the onset of shock; of those patients without shock, best results were seen in patients who had evidence of continuing ischaemia prior to IABP. In patients treated after cardiac surgery, long-term results were favourable inpatients with goodpre-operative left ventricular function andin those who underwent coronary artery bypass grafting or aortic valve replacement. Long-term results inpatients treated with IABP for refractory cardiac failure are encouraging and suggest that IABP should have a continuing role in certain high risk patient groups.

Key Words: Intra-aortic balloon counterpulsation • cardiogenic shock • myocardial infarction • cardiac surgery.


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