The benefit of preoperative intraaortic balloon pumping on hospital and 1-year mortality was assessed in 17 consecutive patients with cardiogenic shock who underwent salvage coronary artery bypass surgery between January 1996 and May 2000. Mean preoperative cardiac index was 1.57 +/- 0 23 L.min(-1).m(-2). Hemodynamic stability was achieved prior to surgery in 14 patients, and mean cardiac index increased to 2.28 +/- 0.64 L.min(-1).m(-2). Hospital mortality was 5.9% (1 patient). Five patients required postoperative intraaortic balloon pumping because of low cardiac output. The duration of intensive care, hospital stay, and the total procedural cost were similar to those reported for high-risk coronary bypass grafting. Cardiac event-free survival was 88.2% (15/17) at 1 year. Intraaortic balloon pumping promises to be an effective therapy for patients in cardiogenic shock who subsequently undergo surgical myocardial revascularization as a salvage procedure.