Cor Vasa 2010, 52(3):127-133 | DOI: 10.33678/cor.2010.037

Intraaortic balloon counterpulsation in intensive cardiac care

Richard Rokyta jr.^*, Jitka Tesařová, Jakub Čech, Vratislav Pechman, Denisa Polívková, Jan Pešek, Jiří Koza, Michal Šmíd, Ivo Bernat

Kardiologické oddělení I. interní kliniky, Fakultní nemocnice Plzeň a Lékařská fakulta v Plzni Univerzity Karlovy v Praze, Česká republika

Aim: To assess the use of intraaortic balloon counterpulsation (IABC) and its indications in an intensive cardiac care unit (ICCU), patients' characteristics, and clinical outcomes.

Methods: Retrospective analysis of patients treated with IABC in an ICCU from January 1, 2005 through December 31, 2008.

Results: Intraaortic balloon counterpulsation was used in 67 patients. The most frequent indications were cardiogenic shock in STEMI patients (61%), cardiogenic shock in non-STEMI patients (21%), and cardiogenic shock of another etiology (9%). In 9% of patients, IABC was used as a support measure before high-risk PCI. The mean IABC treatment duration was 50 hours (max 240 hours). All patients underwent coronary angiography. Complications were observed in 13% of patients. Fifty-five patients had cardiogenic shock due to acute MI. The mean age in this subgroup was 67 ± 9 years (76% were males). In this subgroup, primary PCI was performed in 73% of patients while urgent CABG was indicated in 22% of patients. At IABC initiation, 94% of patients required catecholamines, 80% patients needed invasive mechanical ventilation.
Hospital mortality in patients with cardiogenic shock associated with acute MI was 50%, one-year mortality 55%.

Conclusion: In our ICCU, IABC is part of comprehensive acute cardiac care predominantly in patients with severe cardiogenic shock, mostly due to acute myocardial infarction. Hospital mortality of patients with acute myocardial infarction and cardiogenic shock is comparable with published data.

Keywords: Intraaortic balloon counterpulsation; Acute cardiac care; Cardiogenic shock; Mechanical cardiac support; Hemodynamics; Catecholamines; Acute myocardial infarction

Published: March 1, 2010  Show citation