Document Detail

An improved method of myocardial protection with pulsation during cardiopulmonary bypass.
MedLine Citation:
PMID:  301795     Owner:  NLM     Status:  MEDLINE    
A new valveless pulsatile assist device (PAD) has been developed that converts roller pump flow into synchronized pulsatile flow. The PAD can also be used as an arterial counter-pulsator (ACtP) before and after cardiopulmonary bypass (CPB). The PAD was employed in 100 adult patients undergoing open heart surgery for coronary artery and/or valvular heart disease. Seventy-three of these patients were NYHA class III or IV, had ejection fractions of less than 0.3, or an LVEDP greater than or equal to 18 mm Hg. Sixty-one patients underwent coronary artery bypass alone, 17 valve replacement alone, three ventricular aneurysm alone, 12 combined coronaries and valves, and seven combined coronaries and ventricular aneurysms. The device functioned as a hemodynamically effective ACtP before and after CPB. During CPB, pulse pressures of 40-50 mm Hg were readily obtained. Urinary outputs during CPB were increased on the PAD when compared to a control group (9.18 +/- 0.68 cc/min vs 3.90 +/- 0.34 cc/min). In addition, during CPB, coronary graft blood flow (CBF) increased an average of 21.4 +/- 6.1% with the PAD, and after CPB, CBF increased an average of 25.0 +/- 5.9%. Free plasma hemoglobins after CPB were not elevated. Only one patient had a perioperative myocardial infarction, and this patient was successfully treated with intra-aortic balloon pumping. It is suggested from these data that use of the PAD may decrease both the incidence of perioperative myocardial infarction and the need for postoperative intra-aortic balloon pumping.
D Bregman; F O Bowman; E N Parodi; S M Haubert; R N Edie; H M Spotnitz; K Reemtsma; J R Malm
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  56     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1977 Sep 
Date Detail:
Created Date:  1977-09-29     Completed Date:  1977-09-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  II157-60     Citation Subset:  AIM; IM    
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MeSH Terms
Assisted Circulation / instrumentation*
Blood Flow Velocity
Cardiopulmonary Bypass / methods*
Coronary Artery Bypass
Coronary Circulation
Heart Aneurysm / surgery
Heart Valve Diseases / surgery
Myocardial Infarction / prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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