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Clinical outcomes of grafted vs. percutaneous axillary intra-aortic balloon pump support as a bridge to transplantation: a propensity score-matched analysis

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Abstract

Objectives

The purpose of this study is to investigate the early and late outcomes of axillary intra-aortic balloon pump (IABP) implantation as a bridge to heart transplantation, comparing the grafted technique with the percutaneous technique.

Methods

Between July 2009 and January 2020, 163 patients underwent an axillary IABP insertion as a bridge to heart transplantation. Among them, 97 patients underwent axillary IABP implantation through a graft sutured onto the axillary artery (Group A) and 66 patients underwent percutaneously (Group B). Propensity matching identified 53 matched pairs for analysis (C-statistics 0.741). The primary outcomes of interest included IABP-related complications, success rate of a bridge to transplantation, in-hospital mortality, and late survival.

Results

In the propensity-score matched cohort, there were no significant differences in the baseline characteristics between the two groups. The operation time was significantly longer in Group A than in Group B (141.5 ± 38.3 min vs 42.7 ± 19.3 min, p < 0.01). The complication rates including stroke, re-exploration for bleeding, and aortic event were not significantly different between Group A and B. However, Group A required more transfusion and re-exploration for bleeding. The success rate of a bridge to transplantation was similar between Group A (47/53, 88.7%) and Group B (47/53, 88.7%). There were no significant differences in in-hospital mortality and late survival between two groups.

Conclusion

In the propensity score matching analysis, there were not any significant differences between the two groups in IABP-related complications, in-hospital mortality, and late survival. The percutaneous technique provided a shorter operation time and less requirement of transfusion and re-exploration for bleeding compared to the grafted technique. The percutaneous technique might be favorable when feasible.

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Acknowledgements

We would like to acknowledge the assistance of Team WADA for editorial support.

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Authors and Affiliations

  1. Department of Surgery, Section of Cardiac Surgery, The University of Chicago, 5841S Maryland Avenue, Chicago, IL, MC504060637, USA

    Hidefumi Nishida, David Onsager, Tae Song, Christopher Salerno, Valluvan Jeevanandam & Takeyoshi Ota

  2. Department of Medicine, The University of Chicago Medicine, Chicago, IL, USA

    Sara Kalantari, Ann Nguyen, Bow Chung, Jonathan Grinstein, Gene Kim, Nitasha Sarswat, Bryan Smith & Sean Pinney

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  1. Hidefumi Nishida
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  2. Sara Kalantari
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  3. Ann Nguyen
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  6. Gene Kim
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  7. Nitasha Sarswat
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  10. David Onsager
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  13. Valluvan Jeevanandam
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  14. Takeyoshi Ota
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Corresponding author

Correspondence to Hidefumi Nishida.

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Conflicts of interest

S. Pinney: Consultant of Abbott, Medtronic. V. Jeevanandam: Consultant of Abbott.

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Nishida, H., Kalantari, S., Nguyen, A. et al. Clinical outcomes of grafted vs. percutaneous axillary intra-aortic balloon pump support as a bridge to transplantation: a propensity score-matched analysis. Heart Vessels 37, 1995–2001 (2022). https://doi.org/10.1007/s00380-022-02122-y

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  • DOI: https://doi.org/10.1007/s00380-022-02122-y

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