Intra-Aortic Balloon Pumps as Bridge to Heart Transplantation - A Single Center Experience

Abstract

Purpose An intra-aortic balloon pump (IABP) can help optimize and bridge to transplant (BTT) patients with advanced congestive heart failure. We retrospectively reviewed the application and safety of this technique at our center. Methods Between January 2016 and April 2018, 32 patients underwent IABP as BTT including femoral (n=11), subclavian (n=17), and axillary (n=4) approaches with a median duration of support of 5 (IQR 3;14), 18 (IQR 15;36) and 30 (IQR 18;39) days, respectively. Results The mean age was 57.5 +/- 9.4 years, 15 (48%) had NICM, and 30 (94%) patients were in INTERMACS 1&2 profiles. Prolonged IABP support was associated with significant improvements in mean pulmonary artery pressure (from 35.8 +/- 11.1 to 28.2 +/- 7.9, p=0.02); cardiac index (from 2.0 +/- 0.5 to 2.5 +/- 0.6, p Conclusion IABP provides reasonable hemodynamic support for BTT in many patients with end stage heart failure; however, over one third developed complications of prolonged support. Further investigation is needed to identify which patients are most appropriate for BTT IABP.