山梨医科大学雑誌　第4巻1号　011-020(1989)

Prophylactic Preoperative Application of Intraaortic Balloon
Pump (IABP) Support in Surgery for Severe Valvular
Heart Disease in the Elderly

Tetsunosuke Matsukawa, Ryoichi Hashimoto, Shinpei Yoshii,
Shigeru Hosaka, Hiroshi Nakagomi, Takatoshi Furuya, Osamu Suzuki,
Masahiro Kobayashi, Kihachiro Kamiya, and Akira Ueno

Abstract: Sixteen elderly patients (over 50-years of age) underwent valvular heart surgery between May, 1984 and October, 1988 at our hospital. We evaluated and validated the concepts of elective, prophylactic and preoperative application of IABP to preserve the impaired cardiac, renal and other organ perfusion during induction of anesthesia and/or before induced cardiac arrest and total cardiopulmonary bypass.
Elective and preoperative use of IABP was applied to seven patients whose early and late results were satisfactory. Two other patients required IABP support immediate after cardiopulmonary bypass decreased, one in early and the other in late postoperative period. No complication related to IABP insertion was encountered in any case.
We recognize the advantage of elective, preoperative application of IABP in the elderly to avoid perioperative hemodynamic disarrangement, especially in valvular heart surgery for patients with severe aortic valve stenosis, for elderly (over 65-years) patients with mitral valve lesions in which left ventricular rupture possibly complicates immediate mitral valve replacement and also for patients with moderate or severe cardiac dysfunction complicated with or without coronary diseases. We also recommend preoperative IABP which is used more commonly in order to improve survival with trivial iatrogenic morbidity, because of its generally accepted method, effectiveness and safety.

Key words: Valvular heart surgery, prophylactic intraaortic balloon pumping, elderly patient




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