Perfusion technique for perfusion-assisted direct coronary artery bypass (PADCAB)

The role for the perfusionist has changed at many institutions that perform Off-Pump Coronary Artery Bypass (OPCAB). Surgeons at our hospitals have adapted a technique called Perfusion-Assisted Direct Coronary Bypass (PADCAB) (1). A simple circuit and pump have been devised for the perfusionist to deliver arterial blood to the myocardium immediately after the completion of the distal coronary anastomosis. Flow is controlled by a pressure-sensing servomechanism, and grafts are perfused at systemic or suprasystemic pressure. The pump is capable of delivering optional agents for myocardial vasodilatation, myocardial resuscitation, and for increasing myocardial performance.