Background: The intra-aortic balloon pump(IABP) can be used to bridge
critically ill end-stage heart failure patients to left ventricular
assist device (LVAD) implantation. However, the IABP's potential
association with hemorrhagic complications raises concerns regarding its
utilization in these patients. Aim: We investigated whether preoperative
long-term IABP support increases hemorrhagic complications post-LVAD
implantation. Methods: Ten patients undergoing IABP support prior to
LVAD implantation (IABP-LVAD group) were compared with 16 who did not
require IABP support (LVAD group). Results: Mean duration of IABP
support was 25.8 days. Preoperatively, both groups were comparable in
all measured parameters and indices of end-organ function. Perioperative
(defined as three weeks post-LVAD implantation, including the procedure)
cellular and noncellular blood transfusion requirements were similar
between IABP-LVAD and LVAD groups (19.8 +/- 9.95 vs. 19.76 +/- 29.69 RBC
units, p = 0.96; 3.8 +/- 4.14 vs. 2.0 +/- 6.44 plateletpheresis units p
= 0.84; 23 +/- 16.04 vs. 25.14 +/- 37.8 fresh frozen plasma units, p =
0.45). Perioperative minimum hematocrit (33.6 +/- 5.6 vs. 36.59 +/- 4.8,
p = 0.38) and minimum platelet count (199 +/- 153 vs. 144 +/- 65, p =
0.52) were similar in the two groups. Two patients in the IABP-LVAD
group and three patients in the LVAD group underwent reoperation
post-LVAD implantation for bleeding. Length of ICU stay was longer in
the LVAD group but did not reach statistical significance (6.2 +/- 6.22
days in the IABP-LVAD group versus 13.45 +/- 10.95 days in the LVAD
group, p = 0.06). Conclusions: Long-term IABP support as a bridge to
LVAD implantation is not associated with increased hemorrhagic
complications post-LVAD implantation
