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

Segesser, Ludwig K. von; Kalējs, Mārtiņš; Ferrari, Enrico; Bommeli, Sandra; Maunz, Olaf; Horisberger, Judith; Tozzi, Piergiorgio

doi:10.1016/j.ejcts.2009.05.026

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…There are few investigations of flow dynamics in vivo. 8-11 Theoretical studies in vitro are also rare because of difficulties in making mock circuits for low pressure and a highly collapsible environment, such as the venous system. 12,13 “L”-shaped end-hole venous drainage cannulas were used in the early days of cardiovascular surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of inflow cannula side-hole number on drainage flow characteristics: flow dynamic analysis using numerical simulation

et al. 2018

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We speculate that flow separation at the most proximal site of the side-hole induces stagnation of flow and induces energy loss. This flow separation may hamper the main stream from the end-hole inlet, which is most effective with low shear stress. The EH cannula was associated with the best flow rate and flow profile. However, by increasing side-hole numbers, flow separation occurs on each side-hole, resulting in more energy loss than the EH cannula and flow rate reduction.

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Section: Discussionmentioning

confidence: 99%

Effect of inflow cannula side-hole number on drainage flow characteristics: flow dynamic analysis using numerical simulation

et al. 2018

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“…In another study, Toomasian and McCarthy 3 used femorofemoral CPB assisted by a centrifugal pump in 50 patients. 15 The second study was also made in vivo using a portable extracorporeal oxygenator and a self-expanding cannula. Cannulas used for that study ranged from 18F to 28F.…”

Section: Discussionmentioning

confidence: 99%

“…The first one showed that, with an 18F self-expanding cannula, the theoretical blood flow in animals going through CPB was achieved with a negative pressure of less than j50 mm Hg. 15 The second study was also made in vivo using a portable extracorporeal oxygenator and a self-expanding cannula. The results showed that, with a negative pressure of j43 mm Hg, the theoretical blood flow could be reached with an 18F selfexpanding cannula.…”

Section: Discussionmentioning

confidence: 99%

Performance Increase in Venous Drainage for Mini-Invasive Heart Surgery: Superiority of Self-Expanding Cannulas

Belkoniene

Abdel-Sayed

Favre

et al. 2014

Innovations�(Phila)

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Objective Originally, the Smartcanula principle (collapsed insertion and expansion in situ) was developed for venous drainage by gravity. However, in minimally invasive surgery, augmentation with either constrained force vortex pumps or vacuum is often used. The current study was set up to assess whether smaller diameters of self-expanding venous cannulas are sufficient in conjunction with venous drainage augmentation resulting in smaller access orifices. Methods To evaluate cannulas intended for cardiopulmonary bypass, an in vitro circuit was set up with silicone tubing between the test cannula encased in a lower reservoir, the centrifugal pump, and after an upper reservoir. Afterload was set arbitrarily at 60 mm Hg using a centrifugal pump. The pressure value was measured using Millar pressure transducers. Flow rate (Q) was measured using an ultrasonic flow meter calibrated with volume tank and timer. Revolutions per minute of the centrifugal pump were calibrated with a stroboscope. Data display and data recording were controlled using a Lab View application. Self-expanding (24F Smartcanula) and control (25F Biomedicus) cannulas were used. Results Sixty measurements were recorded. At pump speed of 1500, 1570, 2000, 2500, and 3000 rpm, the Q values were 3.6, 5.2, 6.6, 9.3, and 11.8 L/min for the 24F self-expanding cannula and 3, 4.3, 5.4, 7.5, and 9.3 L/min for the control cannula. The pressure values were 3.6, −5.4, −15.9, −45.3, and 80.6 mm Hg. Biomedicus 25F showed Q values from 16% to 19% less as compared with 24F Smartcanula. The pressure values were 6, 7, 4, 2, and 2 times more as compared with 24F Smartcanula. Conclusions Our experimental evaluation demonstrated the superior performance of the Smartcanula with its self-expanding design in comparison with the reference commercially available standard cannulas. The Smartcanula with its small diameter is particularly welcome for minimally invasive surgery.

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“…When used for cardiopulmonary bypass, they were found to improve flow speeds and reduce venous line pressures. 20 The disadvantage is the difficulty of removal, especially when used for prolonged periods of time.…”

Section: The Ideal Cannula Designmentioning

confidence: 99%