Pulsatile Assist: Clinical Experience in 100 Cases

In this day and age of cardiovascular surgery with cardiopulmonary bypass (CPB), the perfusionist strives to maintain or mimic normal physiologic parameters such as blood gases, electrolytes, blood flows and so on. The surgical team employes such myocardial protection techniques as topical cooling and cardioplegia. The anaesthesiologist endeavours to maintain hemodynamic and respiratory parameters within normal limits. However, during routine CPB, the phasic, pulsatile nature of arterial systemic pressure is completely omitted with current standard extracorporal perfusion equipment. Lack of widespread acceptance of devices to create pulsatile flow during CPB may be a result of the unavailability of safe, simple equipment until recently. Lack of acceptance may also suggest the populus of opinion is that steady "mean" arterial pressure is sufficient to support vital organs ( eg. heart, brain, liver, spleen and kidneys). But previous investigators have recognized that pulsatile flow perfusion has significant clinical advantages. 1 -6•8•9 Several investigators have even demonstrated the effectiveness of using an intra-aortic balloon to create pulsatile flow during CPB.IO,Il Hence, a clinical evaluation of the A VCO Pulsatile Bypass Pump® (PBP) Device, was conducted. The purpose of this paper is to detail our clinical experience with the PBP and outline the benefits we were able to appreciate. Materials and Methods. ________ _