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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objective Assessment of the effectiveness associated with preoperative intra-aortic balloon pump (IABP) treatment on postoperative cardiac performance, morbidity, and mortality. Background Preoperative IABP enhances the end result in poor left ventricular function patients undergoing coronary artery bypass grafting (CABG). Patients and methods A prospective analytical cohort study was conducted on 40 patients with preoperative left ventricular ejection fraction (<40%) who experienced myocardial revascularization (CABG) at Nasser Institute Hospital between February 2014 and July 2016. There was a random allocation of patients before surgery, where group I (N = 20) had been inserted with the IABP 1–2 h before aortic cross-clamp and group II (N = 20) was the control group, which did not have IABP inserted preoperatively. Results The mean cardiac index in group I (IAB) before cardiopulmonary bypass time was 2.49 ± 0.21 and in group II (control) it was 1.99 ± 0.34, with a statistically considerable enhancement among two groups (P = 0.003). The mean ischemic time in group I was 54.20 ± 17.63 and in group II it was 57 ± 10.64, with no statistically significant difference among two groups (P = 0.2). The mean cardiopulmonary bypass time in group I was 75.60 ± 22.73, with a statistically substantial enhancement among two organizations (P = 0.015). The mean mechanical ventilation time (h) was 24.7 ± 1.80 in group I compared with 81.9 ± 31.09 in group II, with a highly statistically significant difference among two groups (P = 0.001). The mean ICU stay (hours) in group II was 138.10 ± 50.27, with a highly statistically significant difference (P = 0.001). The mean NYHA class and the mean left ventricular ejection fraction in group I postoperatively was 1.20 ± 0.40 and 54.78 ± 3.75, respectively, with a highly statistically significant difference in group I (P = 0.001) regarding preoperative and postoperative periods. Conclusion Poor left ventricular function patients undergoing CABG possibly require perioperative IABP assistance to decrease morbidity and mortality.

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