IABP therapy has not been proven to reduce mortality in all-comers with cardiogenic shock complicating acute myocardial infarction (IABP-SHOCK II)
A recent retrospective review of IABP therapy in patients with mechanical complications (ventricular septal rupture [VSR] or mitral regurgitation [MR]) following acute myocardial infarction has proven efficacious in this subset
IABP reduced mortality in patient with shock (61% vs 100%, p = 0.04)
IABP reduced preoperative mortality (11% vs 88%, p <0.001)
Post infarction VSR or MR with signs of cardiogenic shock should be considered for an IABP as a bridge to emergent surgical repair
Patients with mechanical complications without shock were not shown to benefit from an IABP and should undergo cardiac surgery after medical stabilization
References
Kettner J, Sramko M, Holek M, et al. Utility of Intra-Aortic Balloon Pump Support For Ventricular Septal Rupture and Acute Mitral Regurgitation Complicating Acute Myocardial Infarction. American Journal of Cardiology. 2013 Vol 112 Issue 11 Pages 1709-1713
