Intermediate coronary revascularization using the Deltastream blood pump: results from an experimental study

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Conventional cardiopulmonary bypass (heart-lung machine) and complete off-pump techniques for myocardial revascularization present distinct challenges.
• The Deltastream blood pump offers a miniaturized solution for extracorporeal circulation.

Purpose of the Study:

• To evaluate the efficacy of an intermediate on-pump/off-pump myocardial revascularization strategy.
• To compare the effects of this novel approach on myocardial ischemia and hemolysis against standard cardiopulmonary bypass.

Main Methods:

• The study involved 8 mini-pigs undergoing combined on-pump/off-pump myocardial revascularization with the Deltastream pump (Group A).
• Seven control mini-pigs underwent standard myocardial revascularization using the Deltastream pump as a complete heart-lung machine (Group B).
• Blood samples were collected pre- and post-operation to assess ischemia markers (creatine kinase, troponin I, LDH, HBDH) and blood gas metabolism.

Main Results:

• Group A demonstrated significantly less increase in creatine kinase (CK), troponin I, and lactate dehydrogenase (LDH) compared to Group B.
• Hydroxybutyrate dehydrogenase (HBDH) levels increased significantly in Group B post-operation, unlike in Group A.
• Hemodynamic measures and LDH values under luxation were superior in the on-pump/off-pump group (Group A).

Conclusions:

• The intermediate on-pump/off-pump approach using the Deltastream blood pump shows potential for reduced ischemia and hemolysis.
• This technique may serve as a viable alternative to conventional extracorporeal circulation for high-risk patients undergoing myocardial revascularization.
• It could help mitigate adverse events associated with full cardiopulmonary bypass.