Pulsatile flow is not a magic bullet for congenital heart surgery patients during CPB procedures.

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 nonpulsatile perfusion during cardiopulmonary bypass (CPB) procedures.[1] Although early CPB pulsatile pumps introduced 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.[[2]] Despite this, the controversy over the benefits of pulsatile flow during acute and long-term extracorporeal circulation still continues.[4] Our pediatric cardiovascular research team at Penn State Children's Hospital and Penn State College of Medicine has a long-standing dedication to this controversial debate and uses a multidisciplinary translational research approach to further examine this issue.[[5]] 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. Myth: Pulsatile flow eliminates the adverse effects of CPB procedures on vital organ injury and reduces the length of ICU as well as hospital stay for congenital heart surgery patients. The entire CPB circuit, not just the pump, should be optimized in order to safely utilize pulsatile flow for congenital heart surgery patients. [Extracted from the article]