Proceedings

Counterpulsation–An Alternate Use for the Pulsatile Bypass Pump

Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710

^* Address Correspondence To: Steven E. Curtis, Box 3043, Dept. of Surgery, Duke University Medical Center, Durham, North Carolina 27710.

Received: 19 March 1980
Accepted: 9 November 1981

Abstract

The positive effect of counterpulsation on coronary flow is generally accepted. This report describes an experience with the Pulsatile Bypass Pump (PBP)* as a method of providing not only pulsatile perfusion during cardiopulmonary bypass (CPB), but also counterpulsation before and after CPB. Over 18 months, the PBP was utilized in 200 patients, the majority of whom underwent coronary bypass procedures. Eighteen of these patients who required support of cardiac function before CPB, form the subgroup emphasized. With synchronized counterpulsation via the common femoral artery by cut down, the patient was anesthetized and the operative procedure performed. During CPB, the PBP provided pulsatile flow and after bypass was again used for counterpulsation. All 18 patients were weaned from P.BP and survived operation. Diastolic augmentation and systolic unloading were observed by monitoring pressure tracing in the radial artery, while counterpulsating via the femoral artery. In 16 patients cardiac function was preserved without need for further support. Two patients required the IAB, and both recovered. It is concluded that transfemoral counterpulsation by the PBP provides a safe alternate method of cardiac support in the absence of significant peripheral vascular disease for patients who would otherwise be candidates for the IAB.