Echocardiographic comparison of the standard end-hole cannula, the soft-flow cannula, and the dispersion cannula during perfusion into the aortic arch
| Autor: | Ronald K. Grooters, Martha J Stewart, Kent C. Thieman, Robert F. Schneider, Dirk A Ver Steeg |
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| Rok vydání: | 2003 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic arch Adult Male medicine.medical_specialty Mean arterial pressure Cardiac Catheterization Arteriosclerosis Aortic Diseases Hemodynamics Aorta Thoracic Coronary Artery Disease law.invention Postoperative Complications law Risk Factors medicine.artery Internal medicine medicine Cardiopulmonary bypass Humans Coronary Artery Bypass Aged Aorta Cardiopulmonary Bypass business.industry digestive oral and skin physiology Blood flow Equipment Design Middle Aged equipment and supplies Cannula Echocardiography Doppler Perfusion surgical procedures operative Intracranial Embolism Echocardiography Cardiology Surgery Female Cardiology and Cardiovascular Medicine Nuclear medicine business Blood Flow Velocity Echocardiography Transesophageal |
| Zdroj: | The Annals of thoracic surgery. 75(6) |
| ISSN: | 0003-4975 |
| Popis: | Background Dislodgement of aortic arch atheroma caused by a perfusion "jet" from the aortic cannula may be a major cause of atheroemboli during coronary artery surgery when using cardiopulmonary bypass (CPB). Two very different cannulas, the Soft-Flow aortic cannula and the Dispersion cannula, which have been designed to reduce exit velocity (cm/s) during perfusion, are compared with a standard steel tip cannula and to each other. Methods To demonstrate any significant differences transesophageal echocardiography (TEE) was used to measure exit velocity of each cannula at a distance of 1, 2, and 3 cm from the tip and compare flow morphology within the aortic arch. Nine patients in whom the cannula tip could be identified and colored Doppler imaging could demonstrate representative morphology were randomly assigned into one of three groups of 3 patients each: group I, a standard steel-tip end-hole cannula (7.3 mm); group II, the Soft-Flow cannula (8.0 mm); and group III, the Dispersion cannula (8.0 mm). Results The standard steel tip cannula demonstrated a long narrow perfusion jet. The Soft-Flow cannula morphology was made up of multiple smaller exiting jets. The Dispersion cannula demonstrated a broad wedge-shaped perfusion pattern. Perfusion hemodynamics (cardiopulmonary bypass hematocrit in d/L, cardiopulmonary bypass blood flow in L/m, mean arterial pressure during cardiopulmonary bypass mm Hg, and perfusion line pressure in mm Hg) were not significantly different between each group. The mean velocities between group I (318 ± 63 cm/s at 1 cm, 296 ± 60 cm/s at 2 cm, 271 ± 85 cm/s at 3 cm) and group II (351 ± 31 cm/s at 1 cm, 240 ± 103 cm/s at 2 cm, 171 ± 120 cm/s at 3 cm) were not statistically different. Group III (the Dispersion cannula) demonstrated significantly reduced velocities (174 ± 22 cm/s at 1 cm, 138 ± 23 cm/s at 2 cm, 90 ± 36 cm/s at 3 cm) when compared with the other two groups ( p Conclusions The Dispersion cannula is significantly different with a lower perfusion velocity and the elimination of the exiting jet or jets. This cannula warrants further clinical study as it may reduce atheroemboli during cardiopulmonary bypass. |
| Databáze: | OpenAIRE |
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