Efficacy of intra-aortic balloon counter-pulsation in low cardiac output syndrome after cardiac valve replacement: a comparative study

Abstract

Objective To compare the efficacy of intra-aortic balloon counter-pulsation (IABP) for low cardiac output syndrome (LCOS) after aortic valve replacement in aortic valve stenosis vs other valvular diseases, so as to improve the outcomes of IABP in valvular heart diseases. Methods Data of 21 patients who suffered from LCOS after cardiac valve replacement in our department from June 2004 to January 2009 were reviewed. These patients were given IABP with percutaneous puncture of femoral artery for treatment of simple aortic valve stenosis (n=10) and other valvular diseases (n=1 1 ). The successful rate of IABP was compared between these two cohorts. Meanwhile, the successful rate of IABP was also compared between patients who suffered from LCOS and received emergent intraoperative IABP due to difficulty weaning from cardiac bypass (n=10) and those who received IABP in ICU after valve replacement (n=11). Results Eleven of 21 patients experienced successful IABP treatment. The successful rate of IABP was 90.0% (9/10)for simple aortic valve stenosis vs 18.2% (2/11) for other valvular diseases (P＜0.05), 80.0% (8/10) for intraoperative IABP vs 27.3% (3/11) for postoperative IABP (P＜0.05). Conclusion Early target IABP can be useful in improving the outcome of postoperative LCOS in patients with valve replacement. Key words: Counterpulsation; Pumping, intra-aortic balloon; Aortic valve stenosis; Heart valve prosthesis implantation; Treatment outcome