What is a potential risk associated with using a roller pump during cardiac procedures?

The use of a roller pump during cardiac procedures presents several risks, one of which is the potential for aortic dissection. Roller pumps function by mechanically compressing the tubing to propel blood, which can lead to a pulsatile flow and high pressures in the circuit. This high-pressure environment can be transmitted back into the arterial system, potentially causing damage to the aortic wall, particularly if there is pre-existing degeneration or weakness in the vessel wall.

While other risks associated with pump usage can occur, such as decreased arterial pressure due to excessive suction or changes in fluid volume, aortic dissection is particularly concerning in the context of high pressure from the roller pump. It is critical for perfusionists to monitor pressures closely and manage flow rates to mitigate the risk of complications such as aortic dissection during these sensitive surgical procedures.