Work

Prophylactic intra-aortic balloon pump in gastrointestinal cancer surgery: a potential approach to mitigate perioperative ischemic risk in severe coronary artery disease

Year: 2026

Type: article

Abstract: Background: Patients with severe coronary artery disease (CAD) requiring time-sensitive gastrointestinal cancer surgery face a dual challenge: perioperative myocardial ischemia and surgical bleeding. The optimal management strategy in this setting remains undefined. Methods: This single-center retrospective cohort study evaluated the association between prophylactic intra-aortic balloon pump (IABP) placement and perioperative outcomes in 100 patients with angiographically confirmed severe CAD who underwent gastrointestinal cancer surgery between February 2014 and May 2024. Fifty patients received preoperative prophylactic IABP, and 50 served as controls. The primary combined endpoint was perioperative major adverse cardiovascular events (MACE) and all-cause mortality. Secondary outcomes included major bleeding and intensive care unit admission. Results: Prophylactic IABP significantly outperformed conventional management in terms of reducing the primary combined endpoint (4.0% vs. 32.0%, P < 0.001). In the multivariate regression analysis, preoperative IABP placement was an independent protective factor against MACE [OR = 0.026 (0.003–0.199), P < 0.001], while multivessel coronary artery disease was identified as an independent risk factor [OR = 7.387 (1.641–33.253), P = 0.009]. Additionally, major bleeding events were significantly lower in the IABP group (6.0% vs. 22.0%, P = 0.041), and no IABP-related complications occurred. Conclusions: In this retrospective cohort, prophylactic IABP placement was associated with lower rates of perioperative MACE and major bleeding in patients with severe CAD undergoing gastrointestinal cancer surgery. IABP may represent a viable circulatory support strategy in this high-risk population.

Source: Cardio-Oncology

DOI: 10.1186/s40959-026-00568-x