Association between Preoperative Cardiac Left Ventricular Dysfunction and Perioperative Intraaortic Balloon Pump in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery

Authors

  • Go Kusumoto Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan
  • Kenji Shigematsu Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan
  • Kouhei Iwashita Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan
  • Kenji Tominaga Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan
  • Takaaki Totoki Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan
  • Ken Yamaura Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan http://orcid.org/0000-0001-9392-1746

DOI:

https://doi.org/10.1532/hsf.1808

Keywords:

Intra-aortic balloon pump, Off-pump coronary artery bypass surgery, Preoperative cardiac function, LV diastolic function, LV diastolic dysfunction

Abstract

Background: Prophylactic use of intraaortic balloon pump (IABP) reduces hospital mortality in patients with left ventricular (LV) systolic dysfunction undergoing coronary artery bypass surgery (CABG); however, its association in patients with LV diastolic dysfunction is unclear. This retrospective study investigated the association between preoperative LV function and perioperative use of IABP in patients undergoing off-pump CABG (OPCAB) at a university hospital.

Methods: 100 consecutive patients who underwent OPCAB between January 1, 2011 and August 31, 2014 were studied. Preoperative LV function was categorized into four groups based on LV systolic and diastolic function determined with preoperative transthoracic echocardiography. The use of IABP was reviewed from medical records. The Mann-Whitney test, Pearson chi-square test, or Fisher exact test were used.

Results: Patients were categorized into the following groups: normal LV function (n = 43), isolated LV systolic dysfunction (n = 13), isolated LV diastolic dysfunction
(n = 21), and combined LV systolic and diastolic dysfunction (n = 14). Intraoperative IABP use was significantly more frequent in patients with isolated LV systolic dysfunction, isolated LV diastolic dysfunction, and combined LV systolic and diastolic dysfunction than in those with normal LV function (P < .05). Furthermore, IABP was used more frequently in patients who developed combined LV systolic and diastolic dysfunction postoperatively (P < .05). 

Conclusion: Not only the presence of preoperative systolic dysfunction but also LV diastolic dysfunction in the presence of normal LV systolic function were associated with increased use of IABP during and after OPCAB. 

Author Biographies

Go Kusumoto, Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan

Department of Anesthesiology,

Assistant Professor

Kenji Shigematsu, Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan

Department of Anesthesiology

Assistant Professor

Kouhei Iwashita, Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan

Department of Anesthesiology

Assistant Professor

Kenji Tominaga, Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan

Department of Anesthesiology

Assistant Professor

Takaaki Totoki, Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan

Department of Anesthesiology

Clinical fellow

Ken Yamaura, Department of Anesthesiology, Fukuoka University School of Medicine, Fukuoka, Japan

Department of Anesthesiology

Professor and chairman

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Published

2017-08-25

How to Cite

Kusumoto, G., Shigematsu, K., Iwashita, K., Tominaga, K., Totoki, T., & Yamaura, K. (2017). Association between Preoperative Cardiac Left Ventricular Dysfunction and Perioperative Intraaortic Balloon Pump in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery. The Heart Surgery Forum, 20(4), E147-E152. https://doi.org/10.1532/hsf.1808

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