The use of Intra Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery

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Fältnamn	Indikatorer	Metadata
000		04581naa a2200481 4500
001		oai:DiVA.org:uu-408254
003		SwePub
008		200406s2020 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4082542 URI
024	7	a https://doi.org/10.17992/lbl.2020.02.3722 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Gunnarsdottir, Sunna Lu Xiu Univ Iceland, Fac Med, Reykjavik, Iceland4 aut
245	1 0	a The use of Intra Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery
264		c 2020-02-01
264	1	b LAEKNAFELAG ISLANDS-ICELANDIC MEDICAL ASSOC,c 2020
338		a electronic2 rdacarrier
520		a Introduction: Intra-aortic balloon pump (IABP) is a mechanical device that increases cardiac output by increasing diastolic blood flow to the coronary arteries and lowers the afterload of the left ventricle in systole. IABP is primarily used in acute heart failure, that includes patients that have to undergo coronary artery bypass grafting (CABG). Its usage, however, in cardiac surgery has been declining with ongoing controversy regarding its benefits. The aim of this study was to assess the use and indications and outcome of IABP related to CABG surgery. Material and Methods: The study was retrospective and included 2177 patients that underwent CABG at Landspitali during 2001-2018. We compared those who received an IABP with controls, using uni- and multivariate analysis. Long term survival and complications (major adverse cardiovascular and cerebral events, MACCE) was estimated with Kaplan-Meier method. Results: A total of 99 (4.5%) patients received an IABP. The incidence was highest in 2006 (8.9%) and lowest in 2001 (1.7%), but the incidence did not change during the study period (p=0.90). Most patients received the pump before (58.6%) or during (34.3%) CABG, but only 6.1% after surgery. Complication rate was 14.1%, with bleeding from the insertion site in the groin being the most common complication. Thirty day mortality was higher in the IABP group compared with controls (22.2% vs 1.3%, p<0.001) and both 5-year survival (56.4% vs 91.5%, 95% CI: 0.47-0.67) and 5-year MACCE-free survival (46.9% vs 83.0%, 95% CI: 0.38-0.58) were inferior. Conclusions: Less than 5% of patients received IABP in relation to CABG in Iceland and the rate hasn't changed much for the last 18 years. Both the complication rate and 30-day mortality was higher in patients in IABP group and both the long term and MACCE-free survival was much worse, probably mostly related to worse overall clinical condition of the patient that received IABP.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a Intra-aortic balloon pump
653		a coronary artery bypass graft (CABG)
653		a indications
653		a complications
653		a outcome
653		a survival
700	1	a Gunnarsdottir, Erla Liu Tingu Univ Iceland, Fac Med, Reykjavik, Iceland4 aut
700	1	a Heimisdottir, Alexandra Aldisu Univ Iceland, Fac Med, Reykjavik, Iceland4 aut
700	1	a Heidarsdottir, Sunna Runu Univ Iceland, Fac Med, Reykjavik, Iceland4 aut
700	1	a Helgadottir, Solveigu Uppsala universitet,Anestesiologi och intensivvård4 aut0 (Swepub:uu)solhe498
700	1	a Sigurdsson, Martin Ingiu Univ Iceland, Fac Med, Reykjavik, Iceland;Landspitali Univ Hosp, Dept Anesthesia & Intens Care, Reykjavik, Iceland4 aut
700	1	a Gudbjartsson, Tomasu Univ Iceland, Fac Med, Reykjavik, Iceland;Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland4 aut
710	2	a Univ Iceland, Fac Med, Reykjavik, Icelandb Anestesiologi och intensivvård4 org
773	0	t Laeknabladidd : LAEKNAFELAG ISLANDS-ICELANDIC MEDICAL ASSOCg 106:2, s. 63-70q 106:2<63-70x 0023-7213x 1670-4959
856	4	u https://uu.diva-portal.org/smash/get/diva2:1421888/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4	u https://www.laeknabladid.is/media/tolublod/1871/PDF/f01.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-408254
856	4 8	u https://doi.org/10.17992/lbl.2020.02.372

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