Assuntos
Estenose da Valva Aórtica/cirurgia , Enoxaparina/efeitos adversos , Fibrinolíticos/efeitos adversos , Implante de Prótese de Valva Cardíaca , Hematoma/complicações , Complicações Pós-Operatórias/cirurgia , Doenças do Colo Sigmoide/complicações , Varfarina/efeitos adversos , Estenose da Valva Aórtica/epidemiologia , Ponte de Artéria Coronária , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/cirurgia , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , RupturaRESUMO
BACKGROUND: The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined. METHODS: We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared outcomes between patients who received an IABP before surgery (BS, n = 36) and after surgery (AS, n = 28). RESULTS: The AS group had higher operative morbidity (71% vs 42%) and mortality (43% vs 14%) rates than the BS group (P < .02 for both). Furthermore, survival rates were lower in the AS group than in the BS group at 1 year (50% vs 83%) and 3 years (46% vs 80%) (log-rank test, P < .004). CONCLUSIONS: Patients who require IABP after cardiac surgery may have worse outcomes than patients who receive IABP support before surgery. In both groups, after an early peak in mortality, the midterm outcomes were characterized by a reassuring plateau in the survival rates.