A novel technique using echocardiography to evaluate venous cannula performance perioperatively in CPB cardiac surgery

Abstract

This novel Smartcanula design, due to its self-expanding principle, provides superior flow characteristics compared to classic two stage venous cannula used for adult CPB surgery. No detrimental effects were observed concerning blood damage. Echocardiography was effective in analysing venous cannula performance and velocity patterns.

Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases☆

“…As a matter of fact the pump flows achieved in this consecutive series of adult patients are in 97% on or above target (mean 113%), and as a result, augmentation using centrifugal pumps or vacuum is unnecessary as previously reported for randomized experimental studies [3,8] and smaller series for specific indications [4,5,9]. It has also been shown previously in a study comparing self-expanding cannulas (access orifice 30 F) to classic two-stage cannulas (access orifice 48 F), that blood flows more than 10% above the target of 2.4 l/m 2 can be achieved without additional blood trauma [6].…”

“…Interestingly, there is increasing evidence, that venous cannulation relying on the 'collapsed insertion and expansion in situ' concept is not only beneficial in remote venous cannulation, where unmatched flow rates can be achieved with gravity drainage alone [4], but also for central cannulation [5,6]. The present study summarizes our recent experience with systematic use of self-expanding cannulas for both peripheral and central venous cannulation.…”

Superior flow for bridge to life with self-expanding venous cannulas

“…As reported previously, the selfexpanding venous cannulas [7][8][9][10] can be stretched and collapsed with a hollow mandrel, inserted into the venous vasculature over a guide wire through an access orifice similar to the size of the peripheral vein or even smaller [11] and expanded to its nominal diameter of 36 F within the vena cava (typical diameter in adults is >20 mm or 60 F) or to the available luminal width of the access vessel (typical diameter of the femoral vein is 8 mm or 24 F). Already at the iliac level, the vein diameter increases, and, therefore, the narrow segment of a well-positioned self-expanding cannula is relatively short.…”

“…We have previously reported the functional principles of the self-expanding venous cannulas mainly for applications with gravity drainage that is, open heart surgery and miniinvasive cardiac surgery [7][8][9][10]. Briefly, the self-expanding cannula can be stretched and collapsed with a hollow mandrel, inserted into the venous vasculature, for example, through a femoral vein, over a guide wire in open, semi-open or percutaneous fashion [11].…”

“…The present study was designed to assess the potential performance increase by the introduction of next-generation, self-expanding venous cannulas [7][8][9][10] despite a relatively small access orifice. In contrast to the previous reports about the self-expanding cannula, a readyfor-use centrifugal pump is an integral part of this set-up, hence providing, by definition, augmentation of venous drainage.…”