Intraaortic balloon pumping in the treatment of XXXX following open heart surgery--immediate results and long-term prognosis.

@entity1 @entity4289 @entity712 @entity66 @entity998 @entity63 @entity3044 @entity453 @entity340 @entity1063 @entity1002 @entity454
From 1979 through 1986, 90 @entity1 required intraaortic balloon pumping (IABP) due to @entity998 complicating open heart surgery. Preoperatively, functional class III or IV was present in 92%; in @entity1 with @entity453 (n = 54), three-vessel or left main disease was found in 72%; @entity1 with @entity340 (n = 37) generally had multiple surgical procedures or valve re-replacement performed. Intra-IABP mortality was 49% (n = 44) and 30-day mortality 61% (n = 55). The latter figure decreased from 75% in 1979-81 to 53% in 1985-86. Cumulative 5-year survival was 22%. Logistic regression analysis identified as independent predictors of 30 day mortality the necessity for adjuvant treatment with the more powerful "pressure drugs" @entity3044 / @entity1063 , number of @entity4289 , functional classes III-IV, and chronic @entity1002 . Different combinations of these risk factors identified different @entity1 groups with 30-day mortalities ranging from 100% to 0%. The risk factors reflected both @entity712 probably due to severe @entity63 and @entity454 due to advanced @entity66 . Taking the high-risk composition of the material into account, a 5-year survival of 22% cannot be regarded as discouraging. Continued employment of IABP treatment in open heart surgery, using an aggressive approach coupled with individualized inotropic support, seems justified.
