Heart Failure Clinical Trial
Official title:
Evaluation of Prophylactic Use of a Preoperative Intra-Aortic Ballon Pump in High-Risk Coronary Artery Bypass Graft Surgery: A Single-Centre Study
Background: The intra-aortic balloon balloon pump (IABP) has been used as a method of
percutaneous circulatory assistance high surgical risk patients undergoing coronary artery
bypass graft surgery (CABG); Although its applicability has been questioned by clinical
trials showing poor impact to reduce the mortality due to cardiogenic shock associated with
postoperative acute myocardial infarction (AMI), the real benefit reducing mortality in the
postoperative context (PO) has not been determined examined through a prospective study with
an adequate design.
Objective: To compare PO complications such as mortality, perioperative infarction and other
complications in patients with high surgical risk undergoing CABG in comparison with
controls.
Methods: Quasi-experimental, prospective, comparative, non-randomized study. The decision to
place the BIAC is not part of the study and depends on the multidisciplinary decision of a
Heart Team, based on the individualized risk / benefit. The study population consists on high
surgical risk patients with atherosclerotic coronary disease undergoing CABG in our centre
between 2014-2018. Patients are excluded if any condition is present: cardiogenic shock, with
AMI 48 hours prior and / or severe aortic insufficiency. In one group BIAC will be inserted
1-6 hours before surgery (BIAC group) and a second group is control (non-BIAC group). A
minimum 30-day postoperative follow-up of will be performed, with primary end points
(mortality and AMI type V) and secondary end points (additional PO complications).
Analysis: An evaluation of normality distribution K-S will be performed, the means of
quantitative (t-Test) and categorical variables (Fisher or χ² Pearson) will be compared. A
multivariate analysis will be performed with linear logistic regression to evaluate the
influence of age, sex, peripheral arterial disease (PAD) and EuroSCORE-II on the primary
goal. Statistical significance will be considered when p <0.05. Softwares: GraphPad-Prism-5.0
and SPSS-15.0
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