A prospective evaluation of the pulsatile assist device

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Cardiac Surgery Outcomes

Background:

• Pulsatile flow from assist devices may enhance myocardial preservation and reduce perioperative myocardial infarction.
• The pulsatile assist device (PAD) converts roller pump flow to pulsatile flow.
• Clinical benefits of PAD in coronary artery bypass grafting (CABG) require rigorous evaluation.

Purpose of the Study:

• To evaluate the clinical advantages of the pulsatile assist device (PAD) in coronary artery bypass operations.
• To compare myocardial preservation and perioperative infarction rates between PAD and nonpulsatile flow groups.
• To assess potential disadvantages associated with PAD use.

Main Methods:

• Prospective randomized study of 100 consecutive coronary artery bypass operations.
• Utilized serial electrocardiograms (ECGs) for cardiac assessment.
• Employed creatine phosphokinase isoenzyme studies and technetium-labeled pyrophosphate myocardial scans.
• Monitored plasma hemoglobin levels to assess blood trauma.

Main Results:

• No significant difference in myocardial preservation or perioperative infarction was observed between PAD and nonpulsatile flow groups.
• Patients receiving PAD exhibited significantly higher plasma hemoglobin levels, indicating increased blood trauma.
• The study found no demonstrable clinical advantages of PAD in routine coronary bypass operations.

Conclusions:

• The pulsatile assist device (PAD) offers no significant advantages for myocardial preservation or reduction of perioperative myocardial infarction in routine coronary bypass surgery.
• Increased blood trauma, evidenced by higher plasma hemoglobin, is a potential disadvantage of PAD.
• Current evidence suggests limited benefits of PAD in standard coronary artery bypass procedures.