Recent clinical experience with percutaneous intra-aortic balloon pumping.

: From January 1984 to August 1985, 51 out of 2138 patients undergoing cardiac surgery (2.38 per cent) had an intra-aortic balloon pump (IABP) inserted or an attempted insertion. The patients ranged in age from 24 to 68 years (mean 54.2 years). An IABP was inserted preoperatively in four patients, all of whom were in cardiogenic shock; peroperatively in 27 patients who could not be weaned from cardiopulmonary bypass; and postoperatively in 16 patients who had haemodynamic deterioration. Failed insertion occurred in a further four patients. Twenty-eight patients (59.6 per cent) had percutaneous insertion of the balloon, in 17 (36.2 per cent) the common femoral artery was exposed prior to insertion and in two (4.2 per cent) the balloon was inserted into the thoracic aorta. The overall survival rate was 38.3 per cent for patients with successful insertion. Major complications that threatened life or limb occurred in 10.25 per cent of patients. These complications were confined to females and in these patients the percutaneous technique for inserting intra-aortic balloons should be used with caution.