Title: The Role of Intra-Aortic Counterpulsation in High-Risk OPCAB Surgery:
Abstract: Journal of Cardiac SurgeryVolume 18, Issue 4 p. 286-294 The Role of Intra-Aortic Counterpulsation in High-Risk OPCAB Surgery: A Prospective Randomized Study Jan T. Christenson M.D., Ph.D., F.E.T.C.S., Jan T. Christenson M.D., Ph.D., F.E.T.C.S. *Clinic for Cardiovascular SurgerySearch for more papers by this authorMarc Licker M.D., Marc Licker M.D. **Anesthesiology, University Hospital, Geneva, SwitzerlandSearch for more papers by this authorAfksendiyos Kalangos M.D., Afksendiyos Kalangos M.D. *Clinic for Cardiovascular SurgerySearch for more papers by this author Jan T. Christenson M.D., Ph.D., F.E.T.C.S., Jan T. Christenson M.D., Ph.D., F.E.T.C.S. *Clinic for Cardiovascular SurgerySearch for more papers by this authorMarc Licker M.D., Marc Licker M.D. **Anesthesiology, University Hospital, Geneva, SwitzerlandSearch for more papers by this authorAfksendiyos Kalangos M.D., Afksendiyos Kalangos M.D. *Clinic for Cardiovascular SurgerySearch for more papers by this author First published: 18 July 2003 https://doi.org/10.1046/j.1540-8191.2003.02030.xCitations: 65 Address for correspondence: Dr. Jan T. Christenson, M.D., MA, Ph.D., F.E.T.C.S., Clinic for Cardiovascular Surgery, University Hospital, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland. Fax: +41 22 3727634; e-mail: [email protected] hotmail.com This study was supported by a research Grant from Datascope Corp., Fairfield, NJ. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Abstract Background: High-risk patients would benefit the most of OPCAB revascularization. This prospective and randomized study evaluates the efficacy and safety of pre- and perioperative IABC in high-risk OPCAB. Material: Group A—IABC started prior to induction of anesthesia (n = 15); group B—no preoperative IABC (n = 15). Adult high-risk coronary patients to undergo OPCAB. High risk = (minimum 2) EF < 0.30, left main stenosis, unstable angina, redo. Bailout if hemodynamic instability CPB or IABC in group B. Study endpoints (a) cardiac protection (troponin 1, cardiac index (CI), ECG), (b) inflammatory response (lactate, IL-6), (c) clinical outcome (mortality, morbidity). Emergency operations 33%, re-operation 13%, unstable angina 100%, left main 60% and EF 0.29, without group differences. Results: No bailout group A, 10 in group B, p < 0.0001. Postoperative IABC six (group A) and seven patients (group B), during 6.8 ± 5.1 hours (group A) versus 41.2 ± 25.5 hours (group B), p = 0.0110. Myocardial protection without group differences, but CI significantly better in group A. Inflammatory response significantly less in group A. Clinical outcomes: one death, one MI and two renal failure in group B, none in group A. Intensive care unit (ICU) stay 27 ± 3 hours (group A) versus 65 ± 28 hours (group B), p = 0.0017. LOS 8 ± 2 days (group A) versus 15 ± 10 (group B), p = 0.0351. No IABC related complications. Conclusions: Pre- and perioperative IABC therapy offers efficient hemodynamic support during high-risk OPCAB surgery, lowers the risk of hemodynamic instability, is safe and shortens both ICU and hospital length of stay significantly, and is a cost-effective therapy. (J Card Surg 2003; 18:286-294) Citing Literature Volume18, Issue4July 2003Pages 286-294 RelatedInformation