Comparison of Pulsatile and Non-Pulsatile Extracorporeal Circulation on the Pattern of Coronary Artery Blood Flow.
- Author:
Ho Sung SON
1
;
Yong Hu FANG
;
Znuke HWANG
;
Byoung Ju MIN
;
Jong Ho CHO
;
Sung Min PARK
;
Sung Ho LEE
;
Kwang Taik KIM
;
Kyung SUN
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Korea University, Korea. ksunmd@kumc.or.kr
- Publication Type:Original Article
- Keywords:
Regional blood flow;
Coronary artery;
Pulsatile flow;
Cardiopulmonary bypass
- MeSH:
Animals;
Cardiopulmonary Bypass;
Coronary Sinus;
Coronary Vessels*;
Death, Sudden, Cardiac;
Extracorporeal Circulation*;
Heart Arrest;
Humans;
Pulsatile Flow;
Regional Blood Flow;
Swine;
Ultrasonics;
Ventricular Fibrillation
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2005;38(2):101-109
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In sudden cardiac arrest, the effective maintenance of coronary artery blood flow is of paramount importance for myocardial preservation as well as cardiac recovery and patient survival. The purpose of this study was to directly compare the effects of pulsatile and non-pulsatile circulation to coronary artery flow and myocardial preservation in cardiac arrest condition. MATERIAL AND METHOD: A cardiopulmonary bypass circuit was constructed in a ventricular fibrillation model using fourteen Yorkshire swine weighing 25~35 kg each. The animals were randomly assigned to group I (n=7, non-pulsatile centrifugal pump) or group II (n=7, pulsatile T-PLS pump). Extracorporeal circulation was maintained for two hours at a pump flow of 2 L/min. The left anterior descending coronary artery flow was measured with an ultrasonic coronary artery flow measurement system at baseline (before bypass) and at every 20 minutes after bypass. Serologic parameters were collected simultaneously at baseline, 1 hour, and 2 hours after bypass in the coronary sinus venous blood. The Mann-Whitney U test of STATISTICA 6.0 was used to determine intergroup significances using a p value of <0.05. RESULT: The resistance index of the coronary artery was lower in group II and the difference was significant at 40 min, 80 min, 100 min and 120 min (p <0.05). The mean velocity of the coronary artery was higher in group II throughout the study, and the difference was significant from 20 min after starting the pump (p <0.05). The coronary artery blood flow was higher in group II throughout the study, and the difference was significant from 40 min to 120 min (p <0.05) except at 80 min. Serologic parameters showed no differences between the groups at 1 hour and 2 hours after bypass in the coronary sinus blood. CONCLUSION: In cardiac arrest condition, pulsatile extracorporeal circulation provides more blood flow, higher flow velocity and less resistance to coronary artery than non-pulsatile circulation.
