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US Market Report for On-Pump Coronary Artery Bypass Devices 2018 - MedCore

US Market Report for On-Pump Coronary Artery Bypass Devices 2018 - MedCore

  • November 2017
  • 381 pages
  • ID: 5246339
  • Format: PDF
  • iData Research, Inc.


Table of Contents

CPB is also used in heart valve replacement and repair procedures, repair of septal and congenital heart defects and transplants. However, for the purposes of this report, this chapter analyzes the use of CPB specifically in ONCAB procedures. During an ONCAB procedure, the patient’s heart is stopped temporarily while surgeons use a continuous thread and hand sew vessels together to bypass the blockages. During this procedure, a mechanical cardiopulmonary bypass machine keeps the blood circulating through the body. The blood is rerouted through the healthy vessel and blood flow is restored to the heart muscle. Redirecting the blood flow to a pump enables the surgeon to clamp the aorta and stop the heart, resulting in a motionless and bloodless field. This allows the surgeon to precisely perform manual suturing to obtain accurate connections (anastomoses) between the graft vessel and the aorta, as well as effectively bypass the narrowed or obstructed coronary artery. The absence of blood flow and a motionless heart are important factors in ensuring precision and providing consistent, reproducible positive clinical outcomes.

There are some downsides to the use of CPB pumps. Use of the CPB for circulation exposes the patient’s blood to foreign surfaces, which has been shown to increase the incidence of bleeding and short-term neurocognitive defects. This is known as post-perfusion syndrome or “pump head.” Symptoms of post-perfusion syndrome are subtle and include defects associated with attention, concentration, short-term memory, fine motor function and speed of mental and motor responses. Additionally, stopping of the heart may damage the heart muscle. In certain studies, clamping of the aorta has been shown in certain studies to cause the release of particles into the blood stream that may produce blockages in other parts of the body, such as the brain, which may lead to neurological damage, including strokes. Despite these potential complications, the majority of CABG procedures are still performed on-pump. Furthermore, the percentage of total CABG procedures performed on-pump has been increasing year-over-year since 2004.

The majority of coronary artery bypass graft (CABG) procedures are performed with the heart stopped. This type of procedure is termed on-pump coronary artery bypass (ONCAB) because the procedure requires the usage of a cardiopulmonary bypass (CPB). CPB is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump itself is often referred to as a heart-lung machine. In addition to the heart-lung machine, a complete extracorporeal bypass system is composed of various single-use products, called disposables for the purposes of this report. As disposables come into direct contact with the patient’s blood, they cannot be reused for safety reasons and must be disposed of and replaced following each procedure.


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