Temporary assist devices in France 2014–2018: intra-aortic balloon pump: is the technique really outdated?. (25th November 2020)

• Record Type: Journal Article
• Authors: Roubille, F; Akodad, M; Delmas, C; Bonnefoy-Cudraz, E; Huet, F; Leclercq, F; Gaudard, P; Rouviere, P; Gandet, T; Duflos, C; Delseny, D; Battistella, P; Agullo, A; Aguilhon, S; Puymirat, E
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 2
• Publication Date: 2020-11-25
• Subjects: Acute Heart Failure: Non-pharmacological Treatment; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehaa946.1230
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Aims: Intra-aortic balloon pump (IABP) utilization was expected to be quickly abandoned following the IABP-shock trial and its class III, level B of recommendation in the 2016 ESC guidelines. The aim of this study was to evaluate the use of IABP compared to other mechanical support devices in a nationwide approach. Methods: We conducted a retrospective study based on the French national hospital discharge database. All patients implanted by an assist device either by IABP, extracorporeal membrane oxygenation (ECMO) or IMPELLA® from 2014 to 2018 (2 years before/2 years after the 2016 guidelines) were included. The primary endpoint was the incidence of IABP implantation over the years. Secondary endpoints were incidence of total assist devices implantations, ECMO and IMPELLA® implantation. Results: From 2014 to 2018, a total of 18, 872 patients benefited from mechanical support by IABP (n=6, 637, 35.2%), ECMO (n=11, 833, 62.7%) or IMPELLA® (n=402, 2.1%) in France. The incidence of total mechanical support implantations (ECMO and IABP) was constant over the years. IABP implantation decreased progressively from 1, 725 implantations in 2014 to 976 in 2018 (−44%). By contrast, ECMO implantation increased progressively from 1, 919 implantations in 2014 to 2, 715 implantations in 2018 (+42%). IMPELLA® implantations remained stable over the years from 63 (1.7%) implantations in 2014 to 83 (2.1%) in 2018. Conclusion: In this nationwide real-life study, despite a significant decline in IABP implantations over the years since the ESC guidelines, this device remained used in clinical practice with around 1, 000 implantations in 2018. The size of the centers is not strictly correlated with this use, suggesting differential uses depending of the local background. Funding Acknowledgement: Type of funding source: None