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Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy

Department of Cardiothoracic Surgery, Texas Heart Institute, Houston, Texas, USA, Ain Shams University Hospitals, Cairo, Egypt, Dubai Hospital, Dubai, UAE

For reprint information contact: Hossam Eldin Eid, MD Tel: 971 4271 4444 Fax: 971 4271 9340 Department of Cardiothoracic Surgery, Dubai Hospital, P.O. Box 7272, Dubai, UAE.

Intraaortic balloon counterpulsation has become a prerequisite for surgical repair of a left ventricular aneurysm. From October 1991 to October 1996, 60 consecutive patients underwent left ventricular endoaneurysmorrhaphy. Most had associated procedures, mainly coronary artery bypass grafting. Twenty-two patients (36.7%) were in New York Heart Association functional class III or IV preoperatively. These included 16 (26.7%) who had low cardiac output requiring an intraaortic balloon pump in the perioperative period. Pharmacological inotropic support alone was inadequate in 13 of these patients, one required a balloon pump for 5 days preoperatively due to severe low cardiac output, and 2 needed mechanical support postoperatively for ventricular arrhythmia and low cardiac output. The other 44 patients (73.3%) recovered without mechanical support. This study highlights the important role of intraaortic balloon counterpulsation in the surgical treatment of postinfarction left ventricular aneurysm.