Objective: To analyze the effects of perioperative intra-aortic balloon pump (IABP) support in EuroSCORE high-risk patients undergoing cardiac surgery, and evaluate the risk factors associated with mortality and midterm survival.
Methods: Fifty-eight patients with EuroSCORE of no less than 6 underwent cardiac surgery and received peri-operative IABP support, including 29 with preoperative IABP support, 21 with intra-operative IABP support, and 8 with postoperative IABP support. The patients who survived the surgeries were followed up for at least 1 year.
Results: Complications related to IABP support occurred in 2 cases (3.45%). The in-hospital mortality was 6.89% (4/58) in this series. Patients with intra-operative IABP had a lower ejection fraction, and those with pre-operative IABP showed more frequent unstable angina and recent myocardial infarction. The number of emergency procedures was also significantly higher in patients with pre-operative IABP support. Patients with intra- or postoperative IABP support had a longer ICU stay. The 1-year follow-up was completed in 54 patients and 4 deaths were recorded, with a 1-year survival of 86.21%. The 1-year survival rate was significantly higher in patients with preo- and intra-operative IABP support than those with post-operative IABP.
Conclusion: Peri-operative IABP support benefit cardiac support for cardiac surgery, and its preoperative use does not increase the surgical risk. Early prophylactic IABP support according to the EuroSCORE can improve the outcome of the high-risk cardiac surgery.
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Eur Heart J Acute Cardiovasc Care
December 2024
Department of Cardiology, Angiology, Hemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Background: The impact of systemic inflammation in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is still a matter of debate. The present ECLS-SHOCK sub-study investigates the association of C-reactive protein (CRP) levels with short-term outcomes in patients with AMI-CS.
Methods: Patients with AMI-CS enrolled in the multicenter, randomized ECLS-SHOCK trial between 2019 and 2022 were included.
Adv Sci (Weinh)
December 2024
Graduate School of Biomedical Engineering, Faculty of Engineering, and Tyree Institute of Health Engineering (IHealthE), UNSW Sydney, Kensington Campus, Sydney, NSW, 2052, Australia.
Hemodynamic stabilization is crucial in managing acute cardiac events, where compromised blood flow can lead to severe complications and increased mortality. Conditions like decompensated heart failure (HF) and cardiogenic shock require rapid and effective hemodynamic support. Current mechanical assistive devices, such as intra-aortic balloon pumps (IABP) and extracorporeal membrane oxygenation (ECMO), offer temporary stabilization but are limited to short-term use due to risks associated with prolonged blood contact.
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December 2024
Division of Infectious Diseases, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
BACKGROUND Human metapneumovirus (hMPV), classified in the Pneumoviridae family, is primarily known for causing lower respiratory tract infections in children, the elderly, and immunocompromised individuals. However, rare instances have shown that hMPV can also affect other systems, such as the cardiovascular system, leading to conditions like myocarditis. CASE REPORT We describe a 68-year-old man with a medical history of diabetes, hypertension, and liver cirrhosis who presented to the Emergency Department (ED) exhibiting symptoms of fever, cough, and dyspnea.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Department of Cardiology, University Hospital Waterford, Waterford, Ireland.
Background: Acute myocardial infarction-related cardiogenic shock (AMICS) is a severe complication associated with exceedingly high mortality rates. While mechanical circulatory support (MCS) has emerged as a potential intervention, the evidence base for independent MCS use remains weak. In contrast, systematic reviews of observational studies have revealed significant mortality reduction when a combination of MCS was used: VA-ECMO in conjunction with a left ventricular (LV) unloading device (Impella or IABP).
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