Journal article
The comparative effects of pulsatile and nonpulsatile myocardial perfusion during cardiopulmonary bypass
The Journal of surgical research, v 30(6), pp 553-562
Jun 1981
PMID: 7242073
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The salutary effects of pulsatile perfusion (P) during clinical cardiopulmonary bypass (CPB) remain controversial. The notion exists that coronary blood flow may be enhanced by P, especially when a significant coronary stenosis occurs. In this study pressure-flow characteristics were assessed during CPB with and without P in 13 fibrillating dog hearts (37°C). Radionuclide microspheres measured transmural blood flow in normal myocardium (NR) and in regions supplied by collateral coronary arteries (CR) which restrict blood inflow at mean pump pressures of 80 and 50 mm Hg during either P or nonpulsatile perfusion (NP). Retrograde circumflex pressure (RC
P) also served as an index of CR perfusion. At both pressures, mean myocardial blood flow to both NR and CR was not augmented by P despite aortic pulse pressures of approximately 50 mm Hg. Moreover, endocardial/epicardial flow ratios were unchanged from control in both regions after beginning pulsatile flow. At the same time, the mean RCP in CR was not affected by P even though a pulsatile pattern was transmitted across the collateral bed. Thus, the most significant factors affecting transmural blood flow during pulsatile CPB appear to be the coronary perfusion pressure and degree of inflow limitation, not the perfusion wave form. Therefore, any benefits which might be associated with clinical pulsatile perfusion during CPB appear to result from factors other than coronary blood flow augmentation.
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Details
- Title
- The comparative effects of pulsatile and nonpulsatile myocardial perfusion during cardiopulmonary bypass
- Creators
- W. Randolph Chitwood - Department of Surgery, Veterans Administration Medical Center, Durham, North Carolina 27705 USAJames D. Sink - Duke University HospitalRonald C. Hill - Duke University HospitalAndrew S. Wechsler - Duke University Hospital
- Publication Details
- The Journal of surgical research, v 30(6), pp 553-562
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; [Retired Faculty]
- Web of Science ID
- WOS:A1981LX45800003
- Scopus ID
- 2-s2.0-0019470542
- Other Identifier
- 991020705359204721
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- Web of Science research areas
- Surgery