Pulsatile versus nonpulsatile blood flow during cardiopulmonary bypass.

Abstract

Evolution chose pulsatile blood fl ow; man developed pulseless perfusion. ” 1 Controversy surrounding the importance of pulsatile fl ow (PF) dates back to Hippocrates and Aristotle. 2 Development of cardiopulmonary bypass (CPB) in the 1950s accelerated the PF versus nonpulsatile fl ow (NPF) debate, which remains ongoing to this day. 3,4 Numerous animal studies reveal substantial potential bene fi ts of PF when compared with NPF in the acute setting of CPB (hours), but similar such comparisons in humans are not convincing. Increased use of continuous- fl ow left ventricular assist devices (CF-LVAD) has opened the door for quite unique pathophysiological manifestations of chronic NPF (months/ years).