Role of Intraaortic Balloon Pump in Left Ventricular Endoaneurysmorrhaphy

Abstract

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.