Current indications for the intra-aortic balloon pump: The CP-GARO registry

Summary Background Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock. Aims The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data. Methods This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied. Results A total of 172 patients were included (mean age 65.5 ± 12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n = 107; 62.2%), followed by bridge to revascularization (n = 34; 19.8%) and four other “rare” aetiologies (n = 29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%). Conclusions Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.