Intraoperative unidirectional intra aortic balloon pumping in the management of left ventricular power failure

Unidirectional intra aortic balloon pumping (IABP) was applied to 28 adult patients undergoing open heart surgery over a 35 month period. The patients were divided into three groups according to the temporal sequence of initiating IABP. Group A consisted of 4 patients who were in a low output state or in cardiogenic shock prior to study. All patients survived cardiac catheterization and surgery, and 3 (75 %) were long term survivors. Group B included 15 patients who could not be weaned from cardiopulmonary bypass with the usual supportive measures. Twelve patients (80%) were weaned from bypass with IABP, and 11 (73%) were discharged from the hospital. Group C was composed of 9 patients who manifested a low cardiac output syndrome within the first 24 hours following surgery. IABP was initiated in the recovery room. Six patients (67%) were discharged. The total experience with these 28 patients therefore includes 24 patients (86%) who were weaned from IABP, 29 (71%) who were discharged, and 18 (64%) who were long term survivors. The present criteria for the use of IABP in the cardiac surgical patient are defined.