Clinical usefulness of intraaortic balloon pumping in acute myocardial infarction complicated with cardiogenic shock, ventricular septal perforation and mitral regurgitation.

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The effects of intraaortic balloon pumping (IABP) were studied in 91 patients with acute myocardial infarction complicated with cardiogenic shock (75 pts), ventricular septal perforation (VSP) (12 pts), and/or mitral regurgitation (MR) (4 pts). Out of 44 pts with cardiogenic shock in whom IABP was performed, 14 pts could not recover from cardiogenic shock, 6 pts became dependent on IABP and 13 pts survived (29.5%). In contrast, out of the remaining 31 pts with cardiogenic shock who did not undergo IABP because of inability to insert IABP catheter or other reasons and were treated medically, only 3 pts survived (9.7%, p<0.05). After the initiation of IABP, BPd, CI, SVI, SWI, TMG increased significantly, and HR, CVP, PCWP, TPR decreased significantly. comparison of hemodynamic parameters after the initiation of IABP showed that SVI and SWI at 24 hours were higher and CVP lower in survivors. Out of 7 pts with VSP who underwent IABP 2 pts were operated and survived. In conclusion: (1) short-term mortality in pts with cardiogenic shock was significantly lower in IABP-treated group, (2) hemodynamic parameters impoved after IABP, (3) survivors from cardiogenic shock had higher SVI, SWI, BPd, and lower CVP than non-survivors, (4) patients with VSP and MR had worse prognosis in spite of IABP.
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