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Comparison of Pulsatile and Non-Pulsatile Extracorporeal Circulation on the Pattern of Coronary Artery Blood Flow  

Son Ho Sung (Department of Thoracic and Cardiovascular Surgery, Korea University)
Fang Yong Hu (Korea Artificial Organ Center, Korea University)
Hwang Znuke (Department of Thoracic and Cardiovascular Surgery, Korea University)
Min Byoung Ju (Department of Thoracic and Cardiovascular Surgery, Korea University)
Cho Jong Ho (Department of Thoracic and Cardiovascular Surgery, Korea University)
Park Sung Min (Department of Thoracic and Cardiovascular Surgery, Korea University)
Lee Sung Ho (Department of Thoracic and Cardiovascular Surgery, Korea University)
Kim Kwang Taik (Department of Thoracic and Cardiovascular Surgery, Korea University)
Sun Kyung (Department of Thoracic and Cardiovascular Surgery, Korea University)
Publication Information
Journal of Chest Surgery / v.38, no.2, 2005 , pp. 101-109 More about this Journal
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). Extra-corporeal 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.
Keywords
Regional blood flow; Coronary artery; Pulsatile flow; Cardiopulmonary bypass;
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