[Treatment of cardiac failure with an intra-aortic balloon pump]. / Behandling av hjertesvikt med intraaortal ballongpumpe.

ABSTRACT

BACKGROUND: Cardiogenic shock is associated with high mortality. This retrospective study examined the effect of an intra aortic balloon pump (IABP) in patients with decompensated heart failure and hypotension, with or without cardiogenic shock. MATERIAL AND METHODS: 94 patients were treated with IABP from January 1998 to December 2002, at the Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway. The indications for use of IABP were decompensated heart failure with hypotension with or without cardiogenic shock in patients with acute myocardial infarction (n = 41), ventricular septal rupture or mitral insufficiency as a complication to acute cardiac failure (n = 23), severe heart failure waiting for heart transplant (n = 10), unstable angina pectoris (n = 8), myocarditis (n = 6) and miscellaneous (n = 6). RESULTS: Mortality after 30 days was 24 % for all patients, with little variation between the above-mentioned subgroups. Median duration for IABP was 96 hours. Systolic blood pressure and diuresis per hour increased significantly from before to after application of IABP (35 +/- 34 mL/hour versus 95 +/- 77 mL/hour, p < 0.001 and 90 +/- 20 mmHg versus 115 +/- 22 mmHg, p < 0.001). The rate of complications requiring treatment was low with use of IABP (5 out of 94 patients). INTERPRETATION: Treatment with IABP in patients with decompensated heart failure and hypotension is an efficient stabilising treatment and safe to use.