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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 3, May/June 2015
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133
prolonged cardiopulmonary bypasses were identified as factors
affecting mortality rates.
Complications with the IABP were described in previous
studies: limb ischaemia, thrombocytopenia, arterial rupture or
dissection, and sepsis and local infections.
4–6,10,18
Complication
rates have been reported from 26 to 50% in different studies.
The risk factors for IABP complications were stated as increased
age, female gender, duration of IABP treatment, presence of
diabetes mellitus, and having several risk factors (e.g. obesity,
smoking, hypertension, cardiogenic shock, inotropic support,
low cardiac output, increased systemic vascular resistance, and
ankle–brachial pressure index
<
0.8).
In our study, the IABP complication rate was higher in
older patients compared to younger ones (25 vs 12.2%). Mild
thrombocytopeniawas themost frequentlydetectedcomplication.
When thrombocytopenia is detected, IABP therapy is terminated
immediately so that fewer bleeding complications occur.
Limitations: our study was a single-institution, retrospective
study, which had a relatively small sample size. This research
may require repeating in multicentres with randomised trials.
Unaccounted for confounders may have been inherent in such a
retrospective analysis.
Conclusion
IABPs are important cardiac support instruments that are easily
implemented and have beneficial effects for resolving transient
ischaemic situations. Whether young or old, patients who require
IABP support have a high risk of mortality. Moreover, elderly
patients have increased incidences of co-morbid disease, which
makes them even more at risk of death. We suggest that IABP
might be used in the intra-operative period as a prophylactic
device in elderly patients with multiple risk factors.
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