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Intraoperative Use of Intra-Aortic Balloon Pump to Generate Pulsatile Flow During Heart Transplantation: A Single-Center Experience.
James, Les; Dorsey, Michael P; Kilmarx, Sumner E; Yassin, Sallie; Shrivastava, Shashwat; Menghani, Neil; Bajaj, Vikram; Grossi, Eugene A; Galloway, Aubrey C; Moazami, Nader; Smith, Deane E.
Afiliación
  • James L; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Dorsey MP; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Kilmarx SE; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Yassin S; Department of Population Health, New York University Langone Health, New York, New York.
  • Shrivastava S; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Menghani N; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Bajaj V; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Grossi EA; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Galloway AC; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Moazami N; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
  • Smith DE; From the Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York.
ASAIO J ; 70(10): 848-852, 2024 10 01.
Article en En | MEDLINE | ID: mdl-38531093
ABSTRACT
The physiologic impact of pulsatile flow (PF) on end-organ perfusion during cardiopulmonary bypass (CPB) is controversial. Using an intra-aortic balloon pump (IABP) to maintain PF during CPB for patients undergoing heart transplantation (HT) may impact end-organ perfusion, with implications for postoperative outcomes. A single-center retrospective study of 76 patients bridged to HT with IABP was conducted between January 2018 and December 2022. Beginning in May 2022, patients received IABP-generated PF during CPB at an internal rate of 80 beats/minute. Fifty-eight patients underwent HT with the IABP turned off (IABP-Off), whereas 18 patients underwent HT with IABP-generated PF (IABP-On). The unmatched IABP-On group experienced shorter organ ischemia times (180 vs . 203 minutes, p = 0.015) and CPB times (104 vs . 116 minutes, p = 0.022). The cohort was propensity matched according to age, organ ischemia time, and CPB time. Elevations in postoperative lactates in the immediate (2.8 vs . 1.5, p = 0.062) and 24 hour (4.7 vs . 2.4, p = 0.084) postoperative periods trended toward significance in the matched IABP-Off group. There was no difference in postoperative vasoactive inotropic score (VIS), postoperative creatinine, or length of stay. This limited preliminary data suggest that maintaining counterpulsation to generate PF during CPB may improve end-organ perfusion in this patient population as suggested by lower postoperative lactate levels.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Flujo Pulsátil / Trasplante de Corazón / Contrapulsador Intraaórtico Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Flujo Pulsátil / Trasplante de Corazón / Contrapulsador Intraaórtico Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos