Prophylactic Intra-Aortic Balloon Pump Before Ventricular Assist Device Implantation Reduces Perioperative Medical Expenses and Improves Postoperative Clinical Course in INTERMACS Profile 2 Patients

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  • Imamura Teruhiko
    Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo
  • Kinugawa Koichiro
    Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo
  • Nitta Daisuke
    Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
  • Hatano Masaru
    Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
  • Kinoshita Osamu
    Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo
  • Nawata Kan
    Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo
  • Kyo Shunei
    Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo
  • Ono Minoru
    Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo

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Background:Although intra-aortic balloon pump (IABP) is sometimes used before cardiac surgery to achieve better outcome in high-risk patients, the clinical impact of prophylactic IABP support before left ventricular assist device (LVAD) implantation in patients with worsening hemodynamics was unknown.Methods and Results:We enrolled 22 patients with worsening hemodynamics who had received IABP support before LVAD (IABP group), and also enrolled 22 patients receiving neither IABP nor extracorporeal membrane oxygenation before LVAD, who were selected on propensity score matching (non-IABP group). Although both groups had similar preoperative background, the IABP group had shorter postoperative intensive care unit (ICU) stay, and more improved hemodynamics (P<0.05 for all). Serum total bilirubin and creatinine decreased significantly in the IABP group compared with the non-IABP group during 1 month after LVAD implantation (P<0.05 for both). Medical expenses during perioperative ICU stay were significantly lower in the IABP group compared with the non-IABP group, even including the cost of preoperative IABP support (P<0.05).Conclusions:Prophylactic IABP support in heart failure patients with worsening hemodynamics improves post-LVAD clinical course and reduces perioperative medical expenses. (Circ J 2015; 79: 1963–1969)

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  • Circulation Journal

    Circulation Journal 79 (9), 1963-1969, 2015

    一般社団法人 日本循環器学会

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