Risk factors of septicemia and perioperative myocardial infarction in a cohort of patients supported with intra-aortic balloon pump (IABP) in the course of open heart surgery

In 1325 open heart operated (OHO) patients with a perioperative mortality of 5.8% the incidence of septicemia and perioperative myocardial infarction (PMI) were much higher in a cohort of 110 patients given intra-aortic balloon pump (IABP) support during the operative course. Analysis of this cohort...

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Bibliographic Details
Published in:	European journal of cardio-thoracic surgery Vol. 7; no. 3; pp. 153 - 157
Main Authors:	AKSNES, J, ABDELNOOR, M, BERGE, V, FJELD, N. B. J
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Science 1993
Subjects:	Adult Aged Analysis of Variance Biological and medical sciences Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - mortality Chi-Square Distribution Cohort Studies Coronary Disease - complications Endocarditis - complications Female Heart Valve Prosthesis - adverse effects Humans Intra-Aortic Balloon Pumping - adverse effects Intra-Aortic Balloon Pumping - mortality Logistic Models Male Medical sciences Middle Aged Multivariate Analysis Myocardial Infarction - etiology Odds Ratio Postoperative Complications - etiology Postoperative Complications - mortality Risk Factors Sepsis - etiology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Time Factors Heart Human Intensive cardiocirculatory care Infarct Septicemia Cuffed tube Cardiovascular disease Intraoperative Coronary heart disease Treatment Cardiocirculatory assistance Surgery Risk factor Myocardium Aorta Contrepulsation
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Summary:	In 1325 open heart operated (OHO) patients with a perioperative mortality of 5.8% the incidence of septicemia and perioperative myocardial infarction (PMI) were much higher in a cohort of 110 patients given intra-aortic balloon pump (IABP) support during the operative course. Analysis of this cohort showed that peri/postoperative insertion of the pump, the presence of disease in the descending branch of left coronary artery (LAD) and the need of more than one saphenous vein graft were risk factors for PMI. The presence of LAD disease was the only independent risk factor for PMI with an odds ratio (OR) of 4.62. Well known risk factors such as NYHA functional class, emergency, low left ventricular ejection fraction (EF) or elevated end diastolic pressure (EDP) were not prognostic of PMI. Thus, the intraoperative seemed to be more important than the preoperative risk profile for the development of PMI. Independent risk factors for the development of septicemia were the duration of IABP with an OR of 1.5 for each pump day and implantation of a valve prosthesis with an OR of 6.3. To avoid septic complications, this study suggests pump removal as soon as possible.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1010-7940 1873-734X
DOI:	10.1016/1010-7940(93)90039-E