Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Evaluation of the effectiveness of intra-aortic balloon pumpwith a fiber-optic sensor

Authors: L.A. Bockeria, M.M. Alshibaya, O.A. Kovalenko, L.N. Rumyantsev, M.V. Makhalin, Z.M. Cheishvili, M.M. Amirbekov, A.I. Korol'kov, A.R. Kalov

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2019-16-3-175-182

UDC: 616.13-089.8-78:615.47

Link: Clinical Physiology of Blood Circulaiton. 2019; 16 (3): 175-182

Quote as: Boсkeria L.A., Alshibaya M.M., Kovalenko O.A., Rumyantsev L.N., Makhalin M.V., Cheishvili Z.M., Amirbekov M.M., Korol'kov A.I., Kalov A.R. Evaluation of the effectiveness of intra-aortic balloon pump with a fiber-optic sensor. Clinical Physiology of Circulation. 2019; 16 (3): 175–82 (in Russ.). DOI: 10.24022/1814-6910-2019-16-3-175-182

Received / Accepted:  23.07.2019/27.07.2019

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Abstract

Objective. This clinical study is conducted to assess the effectiveness of the fiber-optic system intra aortic balloon counterpulsation (IABP) in patients undergoing cardiac surgery.

Material and methods. 39 patients with acute left ventricular failure that occurred in the intra-or early postoperative period. The study group consisted of 25 men and 14 women. The age of patients ranged from 43 to 77 years, and averaged 63.51±7.27 years. The patients were divided into two groups: Group I (n=20) – patients using a fiber-optic sensor of the counterpulsation balloon, Group II (n=19) – patients with Fluied-Field IABP technology. All 39 patients underwent myocardial revascularization. In 2 (5.1%) patients, endarterectomy was performed from the coronary arteries. In most cases, 26 (66.7%) patients also underwent an operation of geometric reconstruction of the left ventricle according to V.M. Dor. All patients before the operation, a Swan–Ganz catheter was installed to measure central hemodynamic parameters.

Results. The overall mortality was 30.76% (n=12). In the group with conventional cylinders (group II), mortality was 36.84% (n=7) versus 25% (n=5) in the group with a fiber-optic system (group I) (p=0.4). In I group, diastolic blood pressure increased by 20%, average blood pressure increased by 11%, cardiac index (CI) increased by 10%, shock index (SI) increased by 11%, pulmonary artery pressure (PAP) decreased by 12%. There was also a decrease in the final diastolic pressure in the aorta by 6%. In group II, an improvement in hemodynamic parameters is observed: diastolic blood pressure increased by 14%, average blood pressure increased by 9%; CI increased by 7%, SI increased by 8%, there was no significant decrease in PAP (p=0.69). When comparing the parameters of EchoCG before and after the operation, statistical significance was not found in group I and II, except for the PV indicator, which was 37,45±10,14% (p=0.04) in group I, and 34,68±8,09% (p=0.02) in the second, with comparable cardiotonic support, adrenaline – 0.08±0.02 μg/kg/min, dobutamine 10±2 μg/kg/min.

Conclusion. Intra-aortic balloon counterpulsation with a fiber-optic sensor, as an assisted circulatory method, helping to reduce afterload and increasing coronary blood flow to balance the delivery-and-myocard requirements for oxygen, is an effective and least invasive method in the arsenal of assisted circulatory systems that significantly improves central hemodynamic performance.

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About Authors

  • Leo A. Bockeria, Dr. Med. Sc., Professor, Academician of RAS and RAMS, Director; orcid.org/0000-0002-6180-2619
  • Mikhail M. Alshibaya, Dr. Med. Sc., Professor, Head of Department of Surgical Treatment of Coronary Heart Disease; orcid.org/0000-0002-8003-5523
  • Oleg A. Kovalenko, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0003-4485-3964
  • Leonid N. Rumyantsev, Postgraduate; orcid.org/0000-0001-5495-9565
  • Maksim V. Makhalin, Cand. Med. Sc., Researcher
  • Zurab M. Cheishvili, Cand. Med. Sc., Researcher
  • Magomedsalam M. Amirbekov, Cand. Med. Sc., Cardiovascular Surgeon
  • Andrey I. Korol'kov, Postgraduate; orcid.org/0000-0001-5324-9721
  • Astemir R. Kalov, Postgraduate

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