Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

Background: The intra-aortic balloon pumping (IABP) is the most used ventricular mechanical assist device. In recent years, the preoperative use in patients with severe ventricular dysfunction presents itself as a great benefic strategy to the postoperative recovery. This paper aim is to evaluate the IABP post-operative benefit in patients with severe ventricular dysfunction. Methods: From January 2011 to March 2016, 125 patients underwent a coronary artery bypass graft (CABG) with cardiopulmonary bypass and preoperative IABP in Teaching Hospital of the ABC Medical School and Hospital Estadual Mario Covas. The inclusion criteria were the presence of severe ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) less than or equal to 40%, estimated by Doppler echocardiography using the Simpson method. The preoperative LVEF was 30.25% ± 8.53% and the diastolic diameter of the left ventricle (LVDD) 67.75 ± 16.37 mm. IABP was installed approximately 15 hours before the surgery. Results: The patients required the IABP for 2.4 ± 1.58 days, and vasoactive drugs, 4.8 ± 2.12 days. We performed 3.2 ± 1.9 grafts per patient and the total length of stay was 07 ± 5.52 days. Cardiopulmonary bypass time was 67 ± 10.95 minutes and anoxia time, 46.4 ± 10.06 minutes. Twelve patients (9.6%) had pneumonia and four (3.2%), atrial fibrillation. We observed a LVDD reduction to 63 ± 16.26 (p = 0.068) and LVEF enhancement to 36.50 ± 16.86 (p = 0.144). The data were analyzed statistically according to the Wilcoxon test. There were no deaths. Conclusion: The initial experience of the authors with the preoperative IABP in patients with severe left ventricular dysfunction suggests great benefit in post-operative recovery with improvement of LVEF and reduction of LVDD. How to cite this paper: Freitas, A.C.O., Gurian, D.B., Saporito, W.F., Machado, L.N., Horiuti, L. and Pires, A.C. (2016) Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction. World Journal of Cardiovascular Diseases, 6, 321328. http://dx.doi.org/10.4236/wjcd.2016.610036 Received: June 27, 2016 Accepted: October 7, 2016 Published: October 10, 2016 Copyright © 2016 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution-NonCommercial International License (CC BY-NC-SA 4.0). http://creativecommons.org/licenses/by-nc/4.0/ Open Access A. C. O. Freitas et al.