Current indications for the intra-aortic balloon pump: The CP-GARO registry

Arch Cardiovasc Dis. 2018 Dec;111(12):739-748. doi: 10.1016/j.acvd.2018.03.011. Epub 2018 Jun 13.

Abstract

Background: Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock.

Aims: The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data.

Methods: This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied.

Results: A total of 172 patients were included (mean age 65.5±12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n=107; 62.2%), followed by bridge to revascularization (n=34; 19.8%) and four other "rare" aetiologies (n=29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%).

Conclusions: Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.

Keywords: Assistance circulatoire; Cardiogenic shock; Choc cardiogénique; Circulatory assistance; Contre-pulsion par ballonnet intra-aortique; Intra-aortic balloon pump; Registre; Registry.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Female
  • Hospital Mortality
  • Humans
  • Intra-Aortic Balloon Pumping* / adverse effects
  • Intra-Aortic Balloon Pumping* / mortality
  • Male
  • Middle Aged
  • Prospective Studies
  • Recovery of Function
  • Registries
  • Risk Factors
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / mortality
  • Shock, Cardiogenic / physiopathology
  • Shock, Cardiogenic / surgery*
  • Time Factors
  • Treatment Outcome