Vortex pumping for routine cardiac surgery: a comparative study

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Perfusion Technology

Background:

• Vortex pumps are increasingly considered for arterial pumping in routine open-heart surgery.
• Traditional roller pumps have been the standard, but their impact on blood components is a concern.
• Evaluating novel pumping technologies is crucial for improving patient outcomes in cardiac procedures.

Purpose of the Study:

• To prospectively evaluate the Biomedicus vortex pump against the Stockert roller pump in routine coronary artery surgery.
• To compare the two pump types based on hematological parameters, fluid balance, transfusion needs, complement activation, hemolysis, and microbubble transmission.

Main Methods:

• A prospective randomized study involving 16 patients undergoing coronary artery surgery.
• Patients were randomized into two groups: one using a Stockert roller pump (Group S) and the other a Biomedicus vortex pump (Group B).
• Key outcomes measured included hematology, fluid balance, transfusion requirements, complement activation, hemolysis, and microbubble transmission.

Main Results:

• Group B (vortex pump) demonstrated significant improvements in preserving platelet counts compared to Group S (roller pump).
• Vortex pumping led to decreased complement activation and reduced microbubble transmission.
• While requiring different initiation/termination techniques, the vortex pump's afterload sensitivity posed no practical issues for perfusionists.

Conclusions:

• Vortex pumping appears to offer superior blood handling characteristics for routine open-heart surgery.
• The observed benefits in platelet preservation, complement activation, and microbubble transmission suggest potential advantages.
• Further extensive clinical trials are necessary to determine if these improvements translate into measurable clinical benefits for patients.