Five years' experience with intraaortic balloon pumping. The changing of indications and the emergence of prognostic indices.

The authors report their experience with IABP during 5 years. 40 patients have been submitted to this procedure, 31 for spontaneous non-complicated myocardial infarction. Overall survival rate was poor in those non-surgical conditions (8/31); better outcome was obtained if IABP was applied earlier in the course of the infarction and if left ventricular filling was continuously assessed. Therefore, use of prognostic index (such as SWI/PWP) and monitoring of pulmonary wedge pressure is stressed. Incidence of sudden death is high among short term survivors 4 out 5 deaths in 8 short term survivors. Usefulness of IABP in preparation for surgery or/and as postsurgical support is evident in this series (5/7 successes) with the exception of patients who did not come off pump (2 cases) and for whom IABP was ineffective.