The Clinical Application Of Intra-aortic Balloon Pumping In High-risk Patients With Coronary Artery Disease

Background: Following its introduction, intra-aortic balloon pump (IABP) is certificated that depress volume load, decrease myocardial oxygen consume and increase perfusion pressure of coronary artery with many clinical and experimental trials in recently 30 years. IABP is principally applied to stabilize medical and surgical patients with hemodynamic collapse and to increase myocardial oxygen supply, but appears not to decreased in-hospital mortality and improved long-term prognosis of high-risk patients with coronary artery disease. On the other hand, the randomized clinical trials demonstrate that it is the most important factor that infarct related artery is patencied earlier, completely and persistently. However, although effective reperfusion therapy, patients with adverse high risk features continue to have excessive morbidity and mortality, expecially in the frist 48 hours following symptom onset. Consequently, the combination of IABP and primary revascularization is expected to reduce the rate of infarct related artery reocclusion, augment myocardial recovery, and bring out further benefit.Objectives: This article research the patterns of IABP use, associated outcomes, prognosis and complications in the era of the combination of IABP and primary revascularization.Methods: The process and data of in-hospital patients have were recorded with designed table.and analysised by statistic means.Results: According to the criteria described in PAMI-II trial, the 36 cases received IABP were high risk patients. The IABP were used to rescue cardiogenic shock in 16 patients, acute heart failure after AMI in 10 patients, for control of refractory ventricular arrhythmia in 3 patients and unstable angina in 6 patients, prophylaxis using before PCI in 1 patients. IABP improve symptoms in 30 patients(83.4%), unimproved in 4 patients(11.1%), and unknowed in 2 patients(5.6%). The beneficial hemodynamic effects of IABP were presented in first 1-4 hours and evident in 24-48 hours in patients with impaired hemodynamies, the symptom of unstable angina was apparently relieved after...