From January 1986 to March 1988 50 of 1366 patients (3.7%) undergoing cardiac surgery were treated with IABP support. The 50 patients ranged in age from 43 to 79 years (mean: 63.3 years). 88% of them underwent coronary artery bypass grafting, 6% of them mitral valve replacement and the other 6% a combined procedure. IABP was inserted preoperatively in 4 patients (8%) because of cardiogenic shock, and in 18 patients because of unstable angina (36%); intraoperatively as a help during weaning from cardiopulmonary bypass in 8 patients (16%); postoperatively because of hemodynamic deterioration in 20 patients (40%). The IABP was placed by femoral puncture in 39 patients (78%), by femoral cutdown in 6 patients (12%) and by transthoracic aortotomy in 5 patients (10%). All patients received daily infusions of heparin and broad spectrum antibiotics. The overall incidence of complications was 22%. There was no mortality due to IABP-related complications.