Preparing for heart surgery can be nerve-wracking with numerous preoperative procedures and tests that involve clinical assessments and discussion with your cardiologist about the risk, benefits, and recovery process. Quest Medical, Inc. located at One Allentown Parkway, Allen, Texas, has an expert team of medical doctors, cardiologists, and surgeons, capable of producing better patient outcomes. Quest MPS 2 technology (Myocardial Protection System) technology has transformed the standard of care by optimizing the aerobic environment for the myocardium. It has simplified the needs of the patient by offering increased oxygen supply, buffering, adjusting magnesium, and potassium and protecting the heart from detrimental effects of volume overload and unnecessary hemodilution. Quest MPS 2 technology offers a robust way to concentrate potassium and avoid potential blood transfusions with microplegia.

Advantages of Quest MPS 2 Technology – Microplegia

Microplegia is made up of pure blood that protects and maintains cardiac tissue optimally throughout the procedure. It has the unique capability to modulate pressure-controlled flow by modulating delivery, automatically adjusting the changes associated with vascular resistance to optimize distribution. Quest MPS 2 Technology offers an accurate temperature control feature that is adjustable as per cold, warm, or tepid controls as per your command. It offers advanced safety features with a non-occlusive gravity-filled pump, air emboli prevention, and drug delivery control, and monitoring. Microplegia offers advanced features compared to crystalloid cardioplegia. It reduces transient cardiac edema, ventilation, low cardiac output syndrome, inotrope, and low cardiac output.

Features of MPS 2 Technology

Quest Medical MPS 2 technology is designed for flexible case management and intuitive perfusion controls. It has an ischemic run timer, delivery volume measurement controls, flow controls for precision continuous delivery of blood. The machine consists of stepwise enabling technology for transition to microplegia. It has automatic auto pressure-flow adjustment which maintains a constant delivery pressure either antegrade or retrograde. It can simulates and cause arrest with agents for precise adjustable delivery control. It has optimal perfusion with early recovery of metabolism and function that is best achieved with the Quest Medical Myocardial Protection System (MPS 2). It has advanced temperature control and monitoring with a heat exchanger, automatic pressure, and air venting capabilities along with antegrade and retrograde tubing clamps. Quest MPS 2 also includes an air-in-line sensor that prevents delivery of air to the patient, dual-piston primary pump, arrest agent, main pump cassette, circulation pump, and stepper motor control for accuracy and precision.

Role of Cardioplegia in Heart Surgery

Cardioplegia is a pharmacological intervention that temporarily arrests the heart. But Quest MPS 2 Technology has effectively eliminated expensive pharmacological solutions. It has reduced transfusion rates, inotropes, and blood products. The first solution used during cardiopulmonary bypass surgery was potassium citrate which can induce reversible cardiac arrest. It was reported by Dr. Melrose in the early 1950s. But, now, in modern times, Quest MPS 2 Technologies has the potential to reduce the need for a hemoconcentration. Eliminates the current limitations of single or double (high or low potassium) cardioplegia systems. The influx of potassium in patients undergoing cardiac surgery leads to depolarization of the myocardial membrane that causes contraction and subsequent release of calcium ions that lead to diastolic arrest. It results in membrane potential of -85mv in cardiac myocytes, and the influx of sodium ions can lead to depolarization from the positive membrane potential of -45 to -30 mV. Eventually, it leads to an action potential with L-type calcium channels that are targeted to induce cardiac arrest with cardioplegia.

Myocardial Protection System (MPS) in Pediatric Cardiac Surgery

Patients requiring congenital heart surgery can be treated with Quest Myocardial Protection System (MPS 2) technology, which is considered the standard of care for the treatment of children requiring cardiopulmonary bypass. There are various methods and approaches involved including modified ultrafiltration techniques. Quest MPS 2 can improve ventricular function with improved diastolic compliance. It has led to improved lung function with pulmonary compliance and arterial oxygenation. It can lead to decreased pulmonary hypertension and intrapulmonary shunt fraction with decreased pericardial and pleural effusions. It can lead to a reduction of plasma-free water and the return of large portions of residual blood in cardiopulmonary bypass surgery. Hematocrit and plasma protein concentration is increased with a reduction in inflammatory mediators. It can lead to decreased transfusion with decreased blood loss. Hemodynamically, it can result in an increased cardiac index with increased systolic and diastolic pressures. Heart rate and pulmonary vascular resistance decrease with increased myocardial contractility. Quest’s Myocardial Protection System improves ventricular function and pulmonary compliance with increased arterial oxygenation and decreased intrapulmonary shunt fraction and pulmonary hypertension. Patients who undergo cardiac surgery remain stable with a decreased incidence of pericardial and pleural effusions. It decreases the amount of free plasma water with increased plasma protein concentration and decreased the concentration of inflammatory mediators. In general, patients stay in the hospital for a reduced period with a fast recovery rate.

Preparation for Heart Surgery with MPS 2 Technology

Quest’s MPS 2 technology has many benefits for arterial and venous flow. The flow of blood from the ascending aorta to the right atrium is restored. Arterial blood is drawn from the twin roller pump between the arterial cannula and the arterial line filter. Blood is pumped from the low prime ultrafiltration and it flows through the roller pump which creates a driving force, warming the blood and filtering it with air detection and pressure monitoring systems in place. The machine is capable of producing effective results by maintaining hemodynamics and infuses blood from the residual circuit through the aortic cannula. The warm blood flows in a retrograde manner through the MPS machine before removal of the cross-clamp. In general, Quest’s MPS Technology has improved and transformed the mechanisms involved in the heart surgery. It has reduced edema formation, low cardiac outcome, supports blood conversion, and eliminates the intricacies involved in heart surgery. Overall, patients undergoing heart surgery recover faster with improved health and safety.