Barge-Caballero, GonzaloCastel-Lavilla, María A.Almenar-Bonet, LuisGarrido-Bravo, Iris P.Delgado Jiménez, Juan FranciscoRangel Sousa, DiegoGonzález-Costello, JoséSegovia Cubero, JavierFarrero-Torres, MartaLambert Rodríguez, José LuisCrespo-Leiro, María GenerosaHervás-Sotomayor, DanielaPortolés-Ocampo, AnaMartínez-Sellés, ManuelDe la Fuente-Galán, LuisRábago Juan-Aracil, GregorioGonzález-Vílchez, FranciscoMirabet, SoniaMuñiz, JavierBarge-Caballero, Eduardo2020-10-282020-10-282019-06-30Barge-Caballero G, Castel-Lavilla MA, Almenar-Bonet L, et al. Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry. Interact Cardiovasc Thorac Surg. 2019; 29(5):670-6771569-9285http://hdl.handle.net/2183/26566[Abstract] OBJECTIVES To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT). METHODS We studied 169 patients who were listed for urgent HT under VA-ECMO support at 16 Spanish institutions from 2010 to 2015. The clinical outcomes of patients under simultaneous IABP support (n = 73) were compared to a control group of patients without IABP support (n = 96). RESULTS There were no statistically significant differences between the IABP and control groups with regard to the cumulative rates of transplantation (71.2% vs 81.2%, P = 0.17), death during VA-ECMO support (20.6% vs 14.6%, P = 0.31), transition to a different mechanical circulatory support device (5.5% vs 5.2%, P = 0.94) or weaning from VA-ECMO support due to recovery (2.7% vs 0%, P = 0.10). There was a higher incidence of bleeding events in the IABP group (45.2% vs 25%, P = 0.006; adjusted odds ratio 2.18, 95% confidence interval 1.02–4.67). In-hospital postoperative mortality after HT was 34.6% in the IABP group and 32.5% in the control group (P = 0.80). One-year survival after listing for urgent HT was 53.3% in the IABP group and 52.2% in the control group (log rank P = 0.75). Multivariate adjustment for potential confounders did not change this result (adjusted hazard ratio 0.94, 95% confidence interval 0.56–1.58). CONCLUSIONS In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality.engThis is a pre-copyedited, author-produced version of an article accepted for publication in Interactive CardioVascular and Thoracic Surgery following peer review.Heart transplantationExtracorporeal membrane oxygenationIntra-aortic balloon pumpjournal articleopen access