PMID: 6972826Aug 1, 1981Paper

The effect of pulsatile perfusion on preservation of left ventricular function after aortocoronary bypass grafting

Circulation
F H LevineM J Buckley

Abstract

Pulsatile perfusion has been reported to be of value in intraoperative myocardial protection. To evaluate this technique, we studied 26 patients undergoing aortocoronary bypass grafting. Ejection fraction determinations from multigated cardiac blood pool scans, serial hemodynamic monitoring, and total CPK and MB-CPK sampling were performed early (4, 6 and 8 hours after bypass) and 10 days after operation. In 12 patients, pulsatile perfusion was started immediately after aortic cannulation and continued until 10 minutes after cessation of bypass; 14 patients had standard nonpulsatile perfusion. All patients had a single aortic cross-clamping and potassium cardioplegia. Cross-clamp time (46 +/- 3 and 46 +/- 3 minutes [+/- SEM]), total bypass time (94 +/- 4 and 89 +/- 6 minutes), and mean perfusion pressure (82 +/- 5 and 83 +/- 3 mm Hg) were comparable in the pulsatile and nonpulsatile groups, respectively, as were extent of coronary disease and number of bypass grafts. Preoperative and postoperative ejection fractions for pulsatile and nonpulsatile groups, respectively, were 0.57 +/- 0.03 and 0.55 +/- 0.04 before operation, 0.37 +/- 0.03 and 0.40 +/- 0.04 4 hours after bypass, 0.40 +/- 0.03 and 0.46 +/- 0.04 at 6 hours, 0.51 +/- ...Continue Reading

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