Pulsatile Flow is not a Magic Bullet for Congenital Heart Surgery Patients during CPB Procedures

Artif Organs. 2019 Oct;43(10):943-946

The objective of this editorial is to clarify common myths related to the effects of pulsatile flow on circuit optimization and vital organ recovery in congenital heart surgery patients undergoing CPB.

The debate over the importance of pulsatile flow has been discussed since Hippocrates and Aristotle; however, in 1955, Wesolowski performed the initial laboratory studies in pulsatile versus non-pulsatile perfusion during cardiopulmonary bypass (CPB) procedures. Although early CPB pulsatile pumps introduce greater complexity and only marginal benefits in the 1950s and 1960s, a few pulsatile roller pumps showed advanced commercial production and clinical use in the late 1970s and early 1980s after demonstrating lower mortality rates and a decreased need for postoperative intra-aortic balloon pulsation.

The objective of this editorial is to clarify common myths related to the effects of pulsatile flow on circuit optimization and vital organ recovery in congenital heart surgery patients undergoing CPB using data generated at the Penn State Pediatric Cardiovascular Research Center.

The following are the major myths and truths regarding this 60-year controversy.