Background: An intra-aortic balloon pump (IABP) is the most frequently used device as a bridge to surgical repair in cases of myocardial infarction. However, robust evidence of IABP support for patients with postinfarction ventricular septal rupture (VSR) is still lacking. We aimed to investigate the impacts of intra-aortic balloon pump (IABP) support on 30-day outcomes in patients with acute myocardial infarction (AMI) complicated VSR. 

Methods: Retrospective data of patients with VSR after AMI at Fuwai Hospital between April 2002 and August 2020 were analyzed. Patients were initially stratified into 2 groups according to IABP implantation. The 30-day all-cause mortality of patients with or without IABP treatment was analyzed and compared. 

Results: A total of 92 patients (mean age of 67.8± 8.3 years; 46.7% male) were included, and 59 underwent IABP implantation. Patients with IABP treatment were younger and more often male and had a higher BMI level and lower mean blood pressure at the onset of VSR than those without IABP treatment. At 30 days, all-cause death occurred in 21 patients in the IABP group (35.59%) and 31 patients in the group without IABP (93.94%). After adjustment for age, sex, left atrial diameter, left ventricular diameter, perforation diameter and ventricular aneurysm, IABP support was found to be an independent protective predictor of 30-day all-cause mortality (hazards ratio: 0.22; 95% confidence interval: 0.12 to 0.42; p<0.001). 

Conclusions: IABP support is associated with lower 30-day mortality in patients with VSR after AMI. Patients with postinfarction VSR with hemodynamic instability or cardiogenic shock could receive IABP treatment as a bridge to surgical repair.