Utilisation préopératoire du ballon intra-aortique avant pontage aorto-coronarien : impacts hémodynamiques et cliniques

Authors: Poirier, Yann
Advisor: Bertrand, OlivierVoisine, Pierre
Abstract: Coronary artery disease is the leading cause of mortality worldwide. Several different treatments currently exist in order to reduce its incidence and symptomatology. Revascularization by coronary artery bypass graft surgery (CABG) remains the most effective option, however the risks associated with this intervention are considerable. Intra1aortic balloon pump (IABP) is a mechanical cardiac assist1device primarily used for hemodynamically unstable patients undergoing coronary artery bypass grafting. The pump increases diastolic coronary artery blood flow and reduces systolic left ventricular afterload. Use of IABP has been described in various situations but the indications regarding its installation remain weak and controversial. The purpose of this master’s thesis was to assess the impact of preoperative installation of IABP on both mortality and complication rates in patients undergoing CABG. A systemic review of the literature and a meta1 analysis were therefore completed at the Institut universitaire de cardiologie et de pneumologie de Québec. While results showed a reduction in mortality with IABP in randomized controlled trials, such was not the case in retrospective studies. Moreover, many limitations reported in randomized controlled trials demanded careful interpretation in order to identify real observed effects. In light of the controversial results found, we cannot fully encourage the widespread use of preoperative intra1aortic balloon pump, as opposed to the current trend in the literature. In order to better characterize the associated risks regarding this practice, further investigation is required.
Document Type: Mémoire de maîtrise
Issue Date: 2019
Open Access Date: 18 October 2019
Permalink: http://hdl.handle.net/20.500.11794/36960
Grantor: Université Laval
Collection:Thèses et mémoires

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