ArticleAmerican journal of cardiovascular disease2026
Preoperative intra-aortic balloon pump use and clinical outcomes in patients undergoing surgery for mitral regurgitation.
Article in American journal of cardiovascular disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMitral regurgitation (MR) requiring surgical correction poses significant perioperative challenges, particularly in hemodynamically compromised patients. Evidence supporting preoperative intra-aortic balloon pump (IABP) use in this setting remains scarce. This study evaluated the association between preoperative IABP use and clinical outcomes in patients undergoing surgical MR correction.
methodsWe conducted a retrospective cohort study utilizing the Nationwide Readmissions Database (NRD) from 2016 through 2020. Adult patients undergoing surgical mitral valve repair or replacement were identified using validated ICD-10-CM and ICD-10-PCS codes. Patients who received preoperative IABP were compared with those who did not through 1:1 propensity score matching, accounting for baseline clinical characteristics and illness severity. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE). Secondary outcomes included in-hospital mortality, perioperative complications, 30-day readmissions, and length of stay.
resultsAmong 33,644 hospitalizations for surgical MR correction, 1,691 (5.0%) involved preoperative IABP use. Following propensity score matching, 964 pairs were analyzed. Preoperative IABP use was associated with significantly lower rates of MACCE (16.8% vs. 19.6%, P = 0.045), in-hospital mortality (4.7% vs. 6.5%, P = 0.028), ischemic stroke (1.5% vs. 2.3%, P = 0.040), and prolonged mechanical ventilation (7.9% vs. 10.2%, P = 0.014). Thirty-day readmission rates and length of stay were also lower among IABP recipients.
conclusionsPreoperative IABP use was associated with modestly improved in-hospital outcomes and lower short-term readmissions, with the most pronounced benefits among high-acuity patients. These hypothesis-generating findings support a selective, severity-guided role for preoperative IABP, warranting prospective validation.
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