Carotid artery hyperperfusion during open-heart surgery

Krous, Henry F.; Mansfield, P.; Sauvage, Lester R.

doi:10.1016/s0022-5223(19)40661-2

Cited by 16 publications

(3 citation statements)

References 11 publications

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“…Krous et al, in 1971, reported the death of a young girl due to imperfect perfusion of the arch vessels resulting in cerebral haemorrhage and death. 4 In 1975, Humphreys et al found cerebral haemorrhage following open-heart surgery in 16 children. 10 Preferential perfusion of selective aortic arch vessels caused by certain aortic cannula tip designs was identified as a possible source of postoperative neurological defi-cit.…”

Section: Flow Visualizationmentioning

confidence: 99%

Hydrodynamics of the new Medos aortic cannula

2002

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Section: Flow Visualizationmentioning

confidence: 99%

Hydrodynamics of the new Medos aortic cannula

2002

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“…More importantly, for neonatal patients, achieving an equal blood flow distribution between the brain and the lower body is extremely critical which depends on cannula hemodynamics. Cerebral malperfusion can potentially cause neurological complications, fundamental defects in young patients, cerebral hemorrhage and swelling, subdural hematoma, and so forth …”

Section: Introductionmentioning

confidence: 99%

Heart valve inspired and multi‐stream aortic cannula: Novel designs for cardiopulmonary bypass improvement in neonates

Rasooli

Pekkan

2019

Artificial Organs

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In a typical open-heart surgery, the blood flow through the aortic cannula is a critical element of the cardiopulmonary bypass (CPB) procedure. Especially for the neonatal and pediatric CPB flow conditions, the need for small hydraulic diameter and large blood flow results confined turbulent jet flow regimes that exacerbate blood damage and platelet activation. Simultaneously, the confined jet wake leads to complex stagnation and recirculating flows that cause considerable thrombosis, blood, and endothelial cell damage through the aorta. Thus, an ideal neonatal CPB cannula should be able to generate optimal jet expansion so that sufficient cerebral perfusion is achieved through the head-neck vessels to avoid postoperative neurological complications and developmental defects in children. To address these challenges, a formal bio-inspired design framework is conducted to reach the desired cannula function through novel analogous biological components, first-time in literature. Among the biological jet flow regimes studied, the ventricle filling-jet generated through the atrio-ventricle (AV) valves are found to be the most promising. Inspired from human AV valve shapes, 8 different novel cannula designs, considering the size constrains of neonatal and pediatric patients are built via high-accurate micro stereo-lithography.Using 2-dimensional time-resolved particle image velocimetry the turbulent jet wake characteristics are measured and compared. The proposed designs have exhibited a significant improvement as compared to standard circular cannula by around 30% reduction in maximum outflow velocity and more than 80% reduction in potential core length and spatial energy dissipation which results in a lower risk of cardiovascular and blood damage. K E Y W O R D Saortic cannulation, bioinspiration, cardiopulmonary bypass, heart valve, jet flow, particle image velocimetry E234 |

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15] Knowledge regarding arch vessel preferential flow, inadvertent cannulation of the arch vessels and the effect of cannula tip design on the jet-flow characteristics in combination with its orientation in the aortic arch concerning pressure and flow distribution is scarce. [16][17][18][19][20][21] In this in vitro study we investigated the arch vessel pressure and flow distribution comparing a single jet-stream cannula, a multiple jet-stream cannula and the new designed dispersion jetstream cannula.…”

Section: Introductionmentioning

confidence: 99%

An in vitro evaluation of a new cannula tip design compared with two clinically established cannula-tip designs regarding aortic arch vessel perfusion characteristics

2000

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We investigated in vitro aortic arch vessel perfusion characteristics of single and multiple jet-stream cannulae and a new dispersion stream tip aortic cannula. Pressures and flows of all arch vessels were measured while directing cannulae jets at the different arch vessels using 6 l/min pump flow. The highest increase in pressure above the set systemic level of 80 mmHg and increase in flow above the set normal flow distribution in the arch vessels occurred in the jet-streamed arch vessels with the single stream cannula. The values were as follows: 29 mmHg and 118 ml/min for the innominate artery, 28 mmHg and 42 ml/min for the left common carotid artery, and 25 mmHg and 54 ml/min for the left subclavian artery. The dispersion stream cannula showed increases in pressure and flow, followed by the multiple stream cannula. Aortic cannula tips and the orientation of jets are potential sources of imbalances of arch vessel perfusion with possible clinical implications regarding perfusion of arch vessels during extracorporeal circulation.

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Carotid artery hyperperfusion during open-heart surgery

Cited by 16 publications

References 11 publications

Hydrodynamics of the new Medos aortic cannula

Hydrodynamics of the new Medos aortic cannula

Heart valve inspired and multi‐stream aortic cannula: Novel designs for cardiopulmonary bypass improvement in neonates

An in vitro evaluation of a new cannula tip design compared with two clinically established cannula-tip designs regarding aortic arch vessel perfusion characteristics

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