'Pulsatile' Left Atrial-Femoral Artery Bypass

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Abstract
• A left atrial—femoral artery (LA-FA) bypass system was designed to deliver synchronous pulsatile blood flow. We compared it with nonpulsatile LA-FA bypass in its effectiveness to limit infarct extension after ligation of the left anterior descending coronary artery at its origin in 35 dogs. Nonpulsatile LA-FA bypass resulted in a 70% reduction in the size of infarct. The addition of synchronous diastolic counterpulsation (P—LA-FA) further reduced the size of infarct, when compared with that in controls (95%) or animals that underwent LA-FA bypass (83%). Both LA-FA and P—LA-FA bypasses limited infarct extension and reduced mortality after acute coronary occlusion through effective unloading of the left ventricle. The addition of diastolic counterpulsation to LA-FA bypass led to further significant infarct reduction, when compared with LA-FA bypass alone. These effects were most likely secondary to improvements in myocardial blood flow distribution. (Arch Surg 1983;118:965-969)

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