Prognosestellung nach implantation der intraaortalen ballonpumpe in der herzchirurgie

In a prospective study 97 patients with intraoperative low output syndrome, who were operated with heart-lung bypass and received an implantation of an intraaortic ballon pump, were analyzed. All operations were performed between July 1996 and July 1997. Sixty operations were elective and 37 patients were operated in an emergency situation. Twenty-nine of all patients died perioperatively. Sixty-eight patients could be discharged from the hospital. Patients who died perioperatively were significantly older, had a significantly lower LVEF pre- and perioperatively, had a higher catecholamines demand despite the IABP support, were anuric or nearly anuric, had a lower cardiac index, and the total bypass time was significantly longer. All five patients who had received mitral valve procedures died. We conclude that the success or failure of perioperative IABP support can be predicted early after implantation. In patients with low output syndrome despite the IABP support, an implantation of a ventricular assist system should be considered.