Support of the myocardium with intra-aortic balloon counterpulsation following cardiopulmonary bypass.

Intra-aortic balloon counterpulsation (IABC) was instituted in 27 patients in cardiogenic shock who had undergone cardiopulmonary bypass (CPB). Patients who required IABC either prior to CPB or else to be weaned from CPB had a survival rate of 22 per cent (2/9). In contrast, the survival rate for those patients requiring IABC after CPB had been discontinued was 72 per cent (13/18). The composition of these two groups was different. The first group contained primarily patients with either severe coronary artery disease or aortic valve stenosis, whereas the latter group contained patients with either less severe coronary artery disease or mitral valve disease. Most patients had an initial satisfactory response to IABC. The over-all survival rate was 55 per cent (15/27). IABC was particularly beneficial for those patients in cardiogenic shock following CPB who had not had massive and irreveraible myocardial injury.