Comparison of the centrifugal and roller pump in elective coronary artery bypass surgery--a prospective, randomized...

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Hematology

Background:

• Cardiopulmonary bypass is essential for coronary artery bypass surgery.
• The type of pump used may influence patient outcomes.
• Platelet function and hemolysis are critical parameters during bypass.

Purpose of the Study:

• To compare the effects of centrifugal pumps versus roller pumps on platelet function.
• To evaluate the impact on hemolysis and clinical outcomes in patients undergoing coronary artery bypass surgery.

Main Methods:

• Randomized controlled trial involving 34 patients undergoing elective coronary artery bypass surgery.
• Platelet activation assessed via flow cytometry pre-operatively, during bypass, and up to 3 days post-operatively.
• Comparison of outcomes including bypass duration, ischemic time, hospital stay, and mortality.

Main Results:

• Roller pump use led to a significant 250% increase in platelet aggregates post-operatively, with a further fivefold increase by day 3 (p < 0.001).
• Centrifugal pump use did not result in significant changes in platelet aggregation.
• Hemolysis showed a transient 20% increase post-bypass in both groups, resolving by the next day without significant group differences.
• No significant differences were found in bypass duration, ischemic period, hospital stay, or mortality between the groups.

Conclusions:

• Roller pumps induce significantly higher platelet aggregation compared to centrifugal pumps, suggesting increased risk for postoperative thrombotic complications.
• Current evidence does not support the clinical superiority of centrifugal pumps over roller pumps in terms of hemolysis or overall clinical outcomes for this procedure.