What Does a Cardiovascular Perfusionist Do?

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Cardiovascular perfusionists are allied health professionals trained to operate and maintain a cardiopulmonary bypass (CPB) machine, also known as a heart-lung machine. They are an important part of a cardiac surgical team, which includes a cardiothoracic surgeon, anesthesiologist, cardiac care nurses, and operating room technicians.

Cardiovascular perfusionists—also called perfusion technologists or cardiopulmonary perfusionists— perform a vital role during heart surgery by ensuring that the patient remains safe while their heartbeat is temporarily stopped during the operation. Training typically involves two years of focused studies following the completion of a bachelor's degree program.

This article explains what a cardiovascular perfusionist does and what education, certification, and licensing are required to start practicing. It also looks at career opportunities in the United States, including the salary a cardiovascular perfusionist can expect to earn.

An illustration with information about what is a cardiac perfusionist?

Illustration by Michela Buttignol for Verywell Health

What Is a Cardiovascular Perfusionist?

A cardiovascular perfusionist is a healthcare professional who operates the cardiopulmonary bypass machine during open heart surgery and other procedures in which blood flow is interrupted or impaired.

These include:

What Is a Heart-Lung Machine?

The cardiopulmonary bypass machine (heart-lung machine) is designed to maintain the circulation of blood and oxygen through the body when the natural blood flow is interrupted during surgery.

The machine works by pumping the patient's blood into a membrane oxygenator (which simultaneously oxygenates the blood and removes carbon dioxide) before pumping it back into the body. This replicates the action of the heart and lungs.

What Does a Cardiovascular Perfusionist Do?

The cardiovascular perfusionist shares responsibility with the surgeon and anesthesiologist for the maintenance of vital functions during surgery. By commandeering the normal function of the heart and lungs. the perfusionist allows the surgeon to operate on a still, unbeating heart.

During open heart surgery, several thin tubes called cannulas are inserted in blood vessels to redirect the flow. One is inserted into the vena cava (a large vein that carries deoxygenated blood to the heart) while the other is inserted into the aorta (the artery that pumps oxygenated blood from the heart).

The cannulas are then connected to the heart-lung machine, which is overseen and managed by the perfusionist.

Some of the responsibilities assigned to the perfusionist include:

  • Maintaining the CPB equipment regularly
  • Doing a pre-surgical evaluation of the machinery
  • Selecting the appropriate cannulas for the procedure
  • Administering medications to stop the heart and protect it while it is stopped
  • Regulating blood flow and blood temperature during surgery
  • Analyzing the blood chemistry during surgery (including blood gases and electrolytes)
  • Using a device called an intra-aortic balloon pump, when needed, to improve blood flow
  • Re-starting the heart and blood circulation after surgery

The perfusionist may also be responsible for collecting blood from the patient before the surgery (known as autologous blood collection) if a transfusion is anticipated.

Training and Certification

In the United States, a four-year bachelor's degree is required to enroll in an accredited perfusion program. The journey usually takes a minimum of six years from start to finish and involves:

  1. Obtaining a bachelor’s degree: Although no specific undergraduate degree is required, many candidates obtain a bachelor's degree in chemistry, biology, or allied sciences.
  2. Enrolling in an accredited program: According to the American Board of Cardiovascular Perfusion (ABCP), there are 18 accredited programs in the United States. The programs typically involve two years of classroom-based studies with hands-on clinical training.
  3. Passing the board exams: After graduation, you need to complete a minimum of 75 assisted procedures to take the first ABCP board exam covering basic science. After an additional 40 independent procedures, you can sit for the second exam covering clinical applications.
  4. Getting licensed: After obtaining certification as a certified clinical perfusionist (CCP), you need to get fully licensed in the state you intend to practice with the state medical board.
  5. Maintaining certification: Like most healthcare professionals, certified clinical perfusionists are required to take and pass continued medical education (CMEs) courses to maintain certification.

Subspecialties

As a high-demand medical profession, cardiovascular perfusionists can opt to specialize in specific procedures or populations. Some may choose to work in pediatric cardiothoracic surgical units or medical centers specializing in heart, lung, or liver transplants.

There is even a need for perfusionists who can operate a modified heart-lung machine, called extracorporeal membrane oxygenation (ECMO), for people with severe heart or lung failure or those awaiting a lung transplant.

Additional training for subspecialties is required. Although fellowships are rare, there are several available to board-certified perfusionists who want to expand their skill base.

In larger facilities, a perfusionist may be promoted to a senior position to manage junior perfusionists and perfusionist assistants.

Career Outlook

According to the  American Society of Extra-Corporeal Technology (ASECT), there are around 3,700 perfusionists currently employed in the United States. It is regarded as one of the top health careers in the United States with practitioners typically working in an operating room within a hospital or large surgical center.

The demand for cardiovascular perfusionists is great due largely to the scarcity of new applicants. In 2021, only 260 perfusionist candidates applied for the final part of the ABCP exams, among whom 223 passed.

Moreover, with a job vacancy rate of over 12% and a turnover rate of nearly 15%, the demand for perfusionists is expected to grow.

How Much Does a Perfusionist Earn?

The U.S. Bureau of Labor Statistics does not track the salaries of cardiovascular perfusionists, but the most recent nationwide survey published in the Journal of Extra-Corporeal Technology suggests that top earners have the potential to make more than $145,000 annually.

While cardiovascular perfusionists tend to work 40-hour weeks, they are frequently on-call and may be required to work rotating shifts, including days, nights, weekends, and holidays, This is a factor you need to consider if you decide to pursue a career as a perfusionist.

Summary

A cardiovascular perfusionist is an allied medical professional who operates a cardiopulmonary bypass machine (heart-lung machine) used for open heart surgery and other procedures where blood circulation is temporarily interrupted.

Becoming a certified cardiovascular perfusionist takes a minimum of six years, including four years to obtain a bachelor's degree and two years in an accredited perfusionist program.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. SHRM Foundation. Perfusionist.

  3. Sarkar M, Prabhu V. Basics of cardiopulmonary bypass. Indian J Anaesth. 2017;61(9):760-767. doi:10.4103/ija.IJA_379_17

  4. Crosby AD, Sistino JJ. Impact of pre-bypass autologous blood collection on blood transfusion rates. J Extra Corpor Technol. 2019 Sep;51(3):140–146.

  5. American Board of Cardiovascular Perfusion. The American Board of Cardiovascular Perfusion 2021 annual report.

  6. Extracorporeal Life Support Organization. ECLS registry report: international summary.

  7. U.S. Bureau of Labor Statistics. You're a what? Perfusionist?

  8. U.S. Bureau of Labor Statistics. Occupational employment and wages, May 2022: 29-2031 cardiovascular technologists and technicians.

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  10. Lewis DM, Dove S, Jordan RE. Results of the 2015 Perfusionist Salary Study. J Extra Corpor Technol. 2016 Dec;48(4):179–187.

Additional Reading
Andrea Clement Santiago

By Andrea Clement Santiago
Andrea Clement Santiago is a medical staffing expert and communications executive. She's a writer with a background in healthcare recruiting.