THE EFFECT OF INTRA-AORTIC BALLOON PUMP IN PATIENTS WITH LOW EJECTION FRACTION UNDERGOING CORONARY ARTERY BYPASS GRAFTING

Authors

  • T KHAN Department of Cardiac Surgery, Wazirabad Institute of Cardiology Wazirabad, Pakistan
  • T ASHRAF Department of Cardiac Surgery, Punjab Institute of Cardiology Lahore, Pakistan
  • F ROOMI Department of Cardiac Surgery, Wazirabad Institute of Cardiology Wazirabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.214

Keywords:

Coronary artery bypass grafting, Left ventricular ejection fraction, Intra aortic balloon pump

Abstract

This study aimed to assess risk factors that predict the length of stay and 30-day mortality in subjects undergoing CAGB to evaluate the impact of IABP support in patients with low ejection fraction. The prospective study was conducted in the Cardiology Department of Punjab Institute of Cardiology Lahore from January 2022 to January 2023. A total of 315 patients were included in the study. The sample was divided into a study group (n=110, having LVEF ≤ 30%) and a control group (n=205, having EF > 30%). Pre-operative and intraoperative data of the patients were recorded. Post-operative complications were recorded, including LOS in the hospital and 30-day mortality. Patients in the study group required more emergency CABG ( P = .005), and IABP was also used more frequently in patients having EF< 30% (P<.001). LOS in hospital (P<.001) and ICU (P<.001) and 30-day mortality (P=.009) were higher in the study group. According to multivariate logistic regression analysis, in the study group history of cerebrovascular disease ( P = .018), peripheral vascular disease ( P = .004), congestive heart failure ( P = .027), and IABP use ( P = .002) were associated with the rate of 30-day mortality. Moreover, the increased length of hospital stay in these patients was associated with an increase in age (P<.001), hypertension (P=.040), and IABP use (P=.009). Based on the results, it can be concluded that the low ejection fraction positively affects increased LOS and 30-day mortality in subjects undergoing CABG; IABP insertion is a significant predictor of increased LOS and 30-day mortality and increases post-operative complications.

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References

AbuRuz, M. E., Al-Dweik, G., and Al-Akash, H. Y. (2019). Checking the moderating effect of perceived control on the relationship between anxiety and post-operative hospital length of stay among coronary artery bypass graft patients. International journal of general medicine, 79-85.

Anh Hien, H., Tam, N. M., Tam, V., Van Minh, H., Hoa, N. P., Heytens, S., Derese, A., and Devroey, D. (2020). Estimation of the cardiovascular risk using world health organization/international society of hypertension risk prediction charts in Central Vietnam. Plos one 15, e0242666.

Chen, Y.-W., Chen, Y.-H., Su, C.-S., Chang, W.-C., Wang, C.-Y., Liu, T.-J., Hung, Y.-P., Lin, T.-H., Chen, W.-J., and Lee, W.-L. (2020). The characteristics and clinical outcomes of rotational atherectomy under intra-aortic balloon counterpulsation assistance for complex and very high-risk coronary interventions in contemporary practice: an eight-year experience from a tertiary center. Acta Cardiologica Sinica 36, 428.

Escutia-Cuevas, H. H., Suárez-Cuenca, J. A., Espinoza-Rueda, M. A., Macedo-Calvillo, L., Castro-Gutiérrez, A., García-García, J. F., del Sol García-Ortegón, M., Robledo, R., and Mondragón-Terán, P. (2020). Pre-operative use of intra-aortic balloon pump support reduced 30-day mortality in a population with LVEF> 35% and high surgical risk after coronary artery bypass graft surgery. Cardiology 145, 267-274.

Guan, Z., Guan, X., Gu, K., Lin, X., Lin, J., Zhou, W., Xu, M., Wan, F., Zhang, Z., and Song, C. (2020). Short-term outcomes of on-vs off-pump coronary artery bypass grafting in patients with left ventricular dysfunction: a systematic review and meta-analysis. Journal of cardiothoracic surgery 15, 1-12.

He, X.-Y., and Gao, C.-Q. (2019). Peri-operative application of intra-aortic balloon pumping reduced in-hospital mortality of patients with coronary artery disease and left ventricular dysfunction. Chinese medical journal 132, 935-942.

Heuts, S., Lorusso, R., di Mauro, M., Jiritano, F., Scrofani, R., Antona, C., Dato, G. A., Centofanti, P., Ferrarese, S., and Matteucci, M. (2023). Sheathless Versus Sheathed Intra-Aortic Balloon Pump Implantation in Patients Undergoing Cardiac Surgery. The American Journal of Cardiology 189, 86-92.

Iliuta, L., Andronesi, A. G., Diaconu, C. C., Panaitescu, E., and Camburu, G. (2022). Additional Prognostic Value of Tissue Doppler Evaluation in Patients with Aortic Stenosis and Left-Ventricular Systolic Dysfunction Undergoing Aortic Valve Replacement. Medicina 58, 1410.

Jannati, M., and Attar, A. (2019). Intra-aortic balloon pump postcardiac surgery: A literature review. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 24.

Lee, J., and Jang, I. (2020). Predictors affecting post-operative atrial fibrillation in patients after coronary artery bypass graft. Clinical Nursing Research 29, 543-550.

Liang, M., Wang, C., Feng, K., Chen, G., Wang, K., and Wu, Z. (2020). Outcome analysis for prediction of intraaortic balloon pump support failure and long‐term survival in high‐risk patients undergoing mitral valve surgery. Artificial Organs 44, 827-836.

Lorusso, R., Heuts, S., Jiritano, F., Scrofani, R., Antona, C., Actis Dato, G., Centofanti, P., Ferrarese, S., Matteucci, M., and Miceli, A. (2022). Contemporary outcomes of cardiac surgery patients supported by the intra-aortic balloon pump. Interactive CardioVascular and Thoracic Surgery 35, ivac091.

Piepoli, M. F., Abreu, A., Albus, C., Ambrosetti, M., Brotons, C., Catapano, A. L., Corra, U., Cosyns, B., Deaton, C., and Graham, I. (2020). Update on cardiovascular prevention in clinical practice: a position paper of the European Association of Preventive Cardiology of the European Society of Cardiology. European journal of preventive cardiology 27, 181-205.

Ram, E., Sternik, L., Moshkovitz, Y., Iakobishvili, Z., Zuroff, E., Peled, Y., Herscovici, R., and Raanani, E. (2022). Coronary artery bypass grafting following acute coronary syndrome: impact of gender. In "Seminars in Thoracic and Cardiovascular Surgery", Vol. 34, pp. 920-929. Elsevier.

Samanidis, G., Georgiopoulos, G., Bousounis, S., Zoumpourlis, P., and Perreas, K. (2021). Outcomes after intra-aortic balloon pump insertion in cardiac surgery patients. Revista Brasileira de Terapia Intensiva 32, 542-550.

Sun, L. Y., Gaudino, M., Chen, R. J., Eddeen, A. B., and Ruel, M. (2020). Long-term outcomes in patients with severely reduced left ventricular ejection fraction undergoing percutaneous coronary intervention vs coronary artery bypass grafting. JAMA cardiology 5, 631-641.

Vickneson, K., Chan, S.-P., Li, Y., Aziz, B. A., Luo, H. D., Kang, G. S., Caleb, M. G., and Sorokin, V. (2019). Coronary artery bypass grafting in patients with low ejection fraction: what are the risk factors? The Journal of cardiovascular surgery 60, 396-405.

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Published

2023-03-03

How to Cite

KHAN, T., ASHRAF, T., & ROOMI, F. (2023). THE EFFECT OF INTRA-AORTIC BALLOON PUMP IN PATIENTS WITH LOW EJECTION FRACTION UNDERGOING CORONARY ARTERY BYPASS GRAFTING. Biological and Clinical Sciences Research Journal, 2023(1), 214. https://doi.org/10.54112/bcsrj.v2023i1.214