Aortic cannula velocimetry

Groom, Robert C.; Hill, Aaron; Kuban, Barry D.; O’Neill, William; Akl, Bechara F.; Speir, Alan M.; Koningsberg, James; Sprissler, Gregory T; Shakoor, Mohamed; Massimiano, Paul S.; Burton, Nelson A.; Albus, Robert A.; Macmanus, Quentin; Lefrak, Edward A.

doi:10.1177/026765919501000310

Cited by 24 publications

(24 citation statements)

References 8 publications

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“…To our knowledge, changes in the rotational component of aortic blood flow during cardiopulmonary bypass have not been reported previously, and these 715 cm/s. 29 This high-velocity jet not only causes the blast effect on the aortic wall but also generates a transverse component of velocity, hence establishing rotational flow, as shown in our study. We demonstrated that the mean transverse velocity during cardiopulmonary bypass was between 35 and 42 cm/s.…”

Section: Discussionsupporting

confidence: 71%

Changes in aortic rotational flow during cardiopulmonary bypass studied by transesophageal echocardiography and magnetic resonance velocity imaging: a potential mechanism for atheroembolism during cardiopulmonary bypass

et al. 2001

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The human aorta is a curved conduit with a complex three-dimensional geometry. The curvature influences axial velocity distribution and introduces transverse velocity components. Rotational flow in the aorta can be demonstrated during normal pulsatile flow using transesophageal echocardiography. Cardiopulmonary bypass may affect the pattern of rotational flow in the aorta and thus influence the generation of atheroemboli. We investigated rotational flow in the descending aorta using color flow mapping and pulse-wave Doppler on transesophageal echocardiography before and during cardiopulmonary bypass. We correlated our findings with magnetic resonance velocity imaging in a model of a human aortic arch connected to a cardiopulmonary bypass circuit. Before cardiopulmonary bypass, rotational flow in the descending aorta was seen in 37 of 40 patients (93%). In the majority of these patients, rotational flow was in the clockwise direction during systole, looking in the direction of flow (30 of 37 patients, 81%, P < 0.01 vs counterclockwise rotation). During cardiopulmonary bypass, there were almost equal numbers of patients with clockwise (18 patients) and counterclockwise rotation (19 patients). Forty-seven percent of patients with clockwise rotation before cardiopulmonary bypass developed reversal in the direction of rotation to counterclockwise during cardiopulmonary bypass. Twenty-nine percent of patients with counterclockwise rotation developed reversal of the direction of rotation during cardiopulmonary bypass. The transverse velocity component increased during cardiopulmonary bypass regardless of the direction of rotation. We also demonstrated clockwise rotation in the descending aorta of a human aortic arch model connected to a cardiopulmonary bypass circuit using magnetic resonance velocity mapping. Before cardiopulmonary bypass, rotation was predominantly clockwise, while during cardiopulmonary bypass, there was no preferred direction of rotation. The geometry of the aorta, which is fairly constant in all patients, imposes handedness to aortic flow before cardiopulmonary bypass. However, during cardiopulmonary bypass, other extrinsic factors such as aortic cannula orientation may influence the direction of rotation. The change in direction of rotational flow and increase in its transverse velocity component during cardiopulmonary bypass may have implications for atheroembolism and arterial branch perfusion during extended periods of non-pulsatile flow.

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Section: Discussionsupporting

confidence: 71%

Changes in aortic rotational flow during cardiopulmonary bypass studied by transesophageal echocardiography and magnetic resonance velocity imaging: a potential mechanism for atheroembolism during cardiopulmonary bypass

et al. 2001

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“…24 However, it does mean that the results of our study need to be interpreted as being at the lower end of the velocity profile for each cannula, as studies have determined the peak velocity exiting cannulae may be up to 45% higher during pulsatile flow. 18 …”

Section: Discussionmentioning

confidence: 99%

Hydrodynamic evaluation of aortic cardiopulmonary bypass cannulae using particle image velocimetry

et al. 2015

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The high velocity jet from aortic arterial cannulae used during cardiopulmonary bypass potentially causes a "sandblasting" injury to the aorta, increasing the possibility of embolisation of atheromatous plaque. We investigated a range of commonly available dispersion and non-dispersion cannulae, using particle image velocimetry. The maximum velocity of the exit jet was assessed 20 and 40 mm from the cannula tip at flow rates of 3 and 5 L/min. The dispersion cannulae had lower maximum velocities compared to the non-dispersion cannulae. Dispersion cannulae had fan-shaped exit profiles and maximum velocities ranged from 0.63 to 1.52 m/s when measured at 20 mm and 5 L/min. Non-dispersion cannulae had maximum velocities ranging from 1.52 to 3.06 m/s at 20 mm and 5 L/min, with corresponding narrow velocity profiles. This study highlights the importance of understanding the hydrodynamic performance of these cannulae as it may help in selecting the most appropriate cannula to minimize the risk of thromboembolic events or aortic injury.

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“…Groom et al performed in vitro velocimetry measurements during perfusion with 5 aortic cannulae at the exit site within a cast of a human aorta attached to a mock circulatory loop. 15 They demonstrated that the cannula designed with lateral windows and a dispersing cone produced a lower velocity and less concentrated flow pattern at the cannula exit and warned that the use of pulsatile flow doubled the velocity at the cannula exit, which could present a higher risk of atheroembolism generation in patients with atherosclerotic disease in the ascending aorta. Unfortunately, despite using a cannula with lateral windows for the patient who had atheromatous plaque in the distal aorta (Case 3), we could not prevent the plaque rupture.…”

Section: Discussionmentioning

confidence: 99%

Atheromatous Plaque in the Distal Aortic Arch Creating the Potential for Cerebral Embolism During Cardiopulmonary Bypass

Hamano¹,

Ikeda²,

Mikamo³

et al. 2001

Jpn Circ J

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erebral embolism remains one of the most serious complications following cardiopulmonary bypass (CPB). Atherosclerosis of the ascending aorta is associated with a high perioperative risk of stroke after cardiac surgery 1,2 and there are various measures 3-6 to prevent atheroembolic complications during these operations. Most studies of the atheromatous changes of the aorta have focused on the ascending aorta where the arch cannula is inserted and the aortic cross clamp applied. The thoracic aorta, especially at the site just distal to the left subclavian artery, which we have defined as the 'distal aortic arch', has the highest incidence of atherosclerotic aneurysm. We have recently been investigating the influence of the jet stream from the arch cannula routinely used in CPB and the aim of the present study was to clarify the relationship between the atherosclerotic changes of the distal aortic arch and atheroembolic events. Methods PatientsA total of 88 consecutive adult patients who underwent coronary artery bypass surgery were enrolled (66 men, 22 women; age range, 42-83 years, mean age, 63.2 years). Cardiac function was routinely monitored by transesophageal echocardiography (TEE) during surgery in all patients.

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Aortic cannula velocimetry

Cited by 24 publications

References 8 publications

Changes in aortic rotational flow during cardiopulmonary bypass studied by transesophageal echocardiography and magnetic resonance velocity imaging: a potential mechanism for atheroembolism during cardiopulmonary bypass

Changes in aortic rotational flow during cardiopulmonary bypass studied by transesophageal echocardiography and magnetic resonance velocity imaging: a potential mechanism for atheroembolism during cardiopulmonary bypass

Hydrodynamic evaluation of aortic cardiopulmonary bypass cannulae using particle image velocimetry

Atheromatous Plaque in the Distal Aortic Arch Creating the Potential for Cerebral Embolism During Cardiopulmonary Bypass

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