Coronary artery bypass grafting using the "Super Pulse" dynamic pulsatile cardiopulmonary bypass device in patients...

Area of Science:

• Cardiovascular Surgery
• Neurology
• Vascular Surgery

Background:

• Coronary artery disease (CAD) often coexists with severe carotid or intracranial arterial stenosis.
• Traditional cardiopulmonary bypass (CPB) may pose risks for patients with comorbid cerebrovascular disease.
• Maintaining physiologic circulation during CPB is crucial for preventing organ damage.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel dynamic pulsatile CPB technique (Super Pulse CPB) in patients undergoing coronary artery bypass graft (CABG) surgery.
• To compare Super Pulse CPB with conventional CPB and conventional CPB plus intraaortic balloon pumping in high-risk patients.
• To assess the impact of Super Pulse CPB on perioperative neurological and cardiac complications.

Main Methods:

• A prospective study evaluating 45 patients with CAD and >75% carotid or intracranial arterial stenosis undergoing CABG.
• Patients were divided into three groups: conventional CPB (Group I, n=8), conventional CPB with intraaortic balloon pump (Group II, n=8), and Super Pulse CPB (Group III, n=29).
• Perfusion pressures and systolic-diastolic amplitude were monitored; perioperative cerebral disorders and myocardial infarction were assessed.

Main Results:

• Super Pulse CPB (Group III) maintained systolic-diastolic amplitude similar to baseline, significantly better than conventional CPB (Group I).
• No perioperative cerebral disorders or myocardial infarction occurred in Groups II and III.
• In contrast, Group I experienced 3 cases of perioperative cerebral disorders, 2 myocardial infarctions, and 2 in-hospital deaths.

Conclusions:

• Super Pulse CPB demonstrates excellent safety and efficacy in patients with combined coronary and severe cerebrovascular disease.
• The dynamic pulsatile nature of Super Pulse CPB effectively mimics physiologic circulation, reducing perioperative complications.
• This novel CPB technique offers a valuable option for high-risk surgical candidates with complex arterial disease.