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A pulsatile assist device (PAD) for use during cardiopulmonary bypass
The Annals of Thoracic Surgery
|December 1, 1977
Summary
A novel pulsatile assist device (PAD) effectively converts roller pump flow to pulsatile flow, aiding in weaning patients from cardiopulmonary bypass. This device may reduce myocardial infarction and the need for intraaortic balloon pumping post-surgery.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Medical Devices
Background:
- Cardiopulmonary bypass often utilizes roller pumps, which generate non-pulsatile flow.
- Non-pulsatile flow during cardiopulmonary bypass may have adverse hemodynamic effects.
- Arterial counterpulsation is a known technique to support circulation.
Purpose of the Study:
- To introduce and evaluate a novel pulsatile assist device (PAD).
- To assess the PAD's efficacy in converting roller pump flow to pulsatile flow.
- To determine the PAD's utility as an arterial counterpulsator during and after cardiopulmonary bypass.
Main Methods:
- The pulsatile assist device (PAD) was developed to modify roller pump output.
- The PAD was employed in 125 adult patients undergoing open-heart surgery.
- Patient data included New York Heart Association Functional Class and ejection fraction.
Main Results:
- The PAD successfully converted roller pump flow to pulsatile flow.
- Hemodynamically effective arterial counterpulsation was achieved before and after perfusion.
- All patients were successfully weaned from bypass with PAD support.
- Low rates of intraoperative death (1), late death (2), and perioperative myocardial infarction (1) were observed.
Conclusions:
- The PAD is a simple and reliable device for intraoperative counterpulsation.
- The PAD facilitates pulsatile cardiopulmonary bypass.
- Utilizing the PAD may reduce perioperative myocardial infarction and the need for postoperative intraaortic balloon pumping.