Intra-Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Acute myocardial infarction complicated by cardiogenic shock is one of the main reasons of death in severely ill patients. One of the main indications for intra-aortic balloon counterpulsation is acute myocardial infarction complicated by cardiogenic shock. Aortic counterpulsation is associated with the risk of several important complications: bleeding, thrombosis, thrombocytopenia, limb ischemia, and aortic wall damage. The analysis of complications is necessary to better understand the course of myocardial infarction using aortic counterpulsation and to reduce the risk of complications. The aim of the study was to analyze the course of acute myocardial infarction complicated by cardiogenic shock in patients managed by intra-aortic balloon counterpulsation as well as to determine intra-aortic balloon counterpulsation-related complications.
Material and Methods. The course of acute myocardial infarction complicated by cardiogenic shock in patients with aortic counterpulsation was analyzed. Patients were recruited from the Cardiology Intensive Care Unit, Department of Cardiology, Lithuanian University of Health Sciences, during the period of 2004–2010. The study comprised 73 patients: 30 women (41.1%) and 43 men (58.9%).
Results. Atrial fibrillation and asystolia were the most common cardiac complications during counterpulsation. Atrioventricular block was the predominant disorder of cardiac conduction system; acute renal failure was the most common noncardiac complication. Complications such as major bleeding, infection, aortic wall damage, or amputations were not documented in our study. Successful percutaneous coronary intervention was associated with fewer complications and reduced mortality rate.
Conclusions. Aortic counterpulsation may be successfully employed providing significant hemodynamic support with rare major complications in a high-risk patient population. A unique finding of this study is a high rate of successful applications of aortic counterpulsation.