Novel Choices of Cannula for Blood Delivery via Femoral Artery in Pediatric Patients

2020 ◽  
Author(s):  
Tomohiro Yamamoto ◽  
Takeshi Saito ◽  
Shuichi Shiraishi ◽  
Boulos Asfour ◽  
Victor Hraska ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Flow Rate ◽  
Femoral Artery ◽  
Pediatric Patients ◽  
Introducer Sheath ◽  
Artery Cannulation ◽  
Extension Tube ◽  
Aortic Arch Repair ◽  
Inner Diameter

AbstractWe previously presented a cardiopulmonary bypass (CPB) method with blood delivery via femoral artery cannulation for pediatric aortic arch repair operations using the Radifocus Introducer sheath. However, the flow rate with the Radifocus Introducer sheath is limited by accessory parts with the same structure having a smaller inner diameter among different sizes, rather than the sheath body. Therefore, we further devised a combination of the JELCO IV catheter, an extension tube, and a three-way stopcock with a larger opening to obtain more flow rate keeping the CPB circuit pressure significantly lower than when using the Radifocus Introducer sheath successfully.

scholarly journals Femoral artery cannulation combined with axillary artery cannulation is safe for Stanford type A aortic dissection

2020 ◽  
Author(s):  
Ling-chen Huang ◽  
Qi-chen Xu ◽  
Dao-zhong Chen ◽  
Xiao-fu Dai ◽  
Liang-wan Chen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Femoral Artery ◽  
Axillary Artery ◽  
Type A ◽  
Clinical Results ◽  
Type A Aortic Dissection ◽  
Artery Cannulation ◽  
Surgical Data ◽  
Perfusion Time

Abstract Background The optimal cannulation strategy in surgery for Stanford type A aortic dissection is critical to the patients’ survival, but remains controversial. Different cannulation strategies have their own advantages and drawbacks during cardiopulmonary bypass. Our center used femoral and axillary artery cannulation for Stanford type A aortic dissection. The purpose of this study was to review and clarify the clinic outcome of femoral artery cannulation combined with axillary artery cannulation for the treatment of type A aortic dissection. Methods We performed a retrospective study that included 327 patients who were surgically treated for type A aortic dissection in our institution from January 2017 to June 2019.Using femoral and axillary artery cannulation to establish cardiopulmonary bypass in patients with type A aortic dissection. The demographics data and surgical data, clinical results of the patients were calculated. Results Femoral artery combined with axillary artery cannulation was technically successful in 327 patients. The cardiopulmonary bypass time was 141.60 ± 34.89 minutes, and the selective antegrade cerebral perfusion time was 14.94 ± 2.76 minutes. The early mortality was 3.06%. The incidence of permanent neurologic dysfunction was 0.92%. Sixteen patients had post-operative renal insufficiency and five patients with liver failure. Two patients ended up with paraplegia. Conclusion Femoral artery combined with axillary artery cannulation for type A aortic dissection can significantly reduce the occurrence of malperfusion syndrome and nervous system complications, especially for cerebral protection.

scholarly journals Cannula position and Bernoulli effect contribute to leg malperfusion during extracorporeal life support with femoral arterial cannulation—an in silico simulation study

2019 ◽  
Vol 29 (2) ◽  
pp. 312-319 ◽  
Author(s):  
Markus Bongert ◽  
Johannes Gehron ◽  
Marius Geller ◽  
Andreas Böning ◽  
Philippe Grieshaber
Keyword(s):  
Cardiac Output ◽  
Flow Rate ◽  
Femoral Artery ◽  
Life Support ◽  
Vascular System ◽  
Extracorporeal Life Support ◽  
Human Aorta ◽  
Limb Ischaemia ◽  
Artery Cannulation ◽  
Cannulation Site

Abstract OBJECTIVES Limb ischaemia during extracorporeal life support (ECLS) using femoral artery cannulation is frequently observed even in patients with regular vessel diameters and without peripheral arterial occlusive disease. We investigated underlying pathomechanisms using a virtual fluid-mechanical simulation of the human circulation. METHODS A life-sized model of the human aorta and major vascular branches was virtualized using 3-dimensional segmentation software (Mimics, Materialise). Steady-state simulation of different grades of cardiac output (0–100%) was performed using Computational Fluid Dynamics (CFX, ANSYS). A straight cannula [virtualized 16 Fr (5.3 mm)] was inserted into the model via the left common femoral artery. The ECLS flow was varied between 1 and 5 l/min. The pressure boundary conditions at the arterial outlets were selected to demonstrate the downstream vascular system. Qualitative and quantitative analyses concerning flow velocity and direction were carried out in various regions of the model. RESULTS During all simulated stages of reduced cardiac output and subsequently adapted ECLS support, retrograde blood flow originating from the ECLS cannula was observed from the cannulation site up to the aortic bifurcation. Analysis of pressure showed induction of zones of negative pressure close to the cannula tip, consistent with the Bernoulli principle. Depending on cannula position and ECLS flow rate, this resulted in negative flow from the ipsilateral superficial femoral artery or the contralateral internal iliac artery. The antegrade flow to the non-cannulated side was generally greater than that to the cannulated side. CONCLUSIONS The cannula position and ECLS flow rate both influence lower limb perfusion during femoral ECLS. Therefore, efforts to optimize the cannula position and to avoid limb malperfusion, including placement of a distal perfusion cannula, should be undertaken in patients treated with ECLS.

Lower Limb Compartment Syndrome after Femoral Artery Cannulation for Cardiopulmonary Bypass

2013 ◽  
Vol 79 (4) ◽  
pp. 175-176
Author(s):  
Patrick D. Rudersdorf ◽  
Matthew D. Whealon ◽  
Amir Abolhoda
Keyword(s):  
Cardiopulmonary Bypass ◽  
Compartment Syndrome ◽  
Femoral Artery ◽  
Lower Limb ◽  
Artery Cannulation

OC03 AXILLARY VERSUS FEMORAL ARTERY CANNULATION IN AORTIC ARCH SURGERY

2018 ◽  
Vol 19 ◽  
pp. e1-e2
Author(s):  
L. Di Marco ◽  
M. Berardi ◽  
A. Leone ◽  
G. Murana ◽  
G. Coppola ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Femoral Artery ◽  
Aortic Arch Surgery ◽  
Artery Cannulation

scholarly journals Peripheral vascular complications following totally endoscopic cardiac surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ling-chen Huang ◽  
Qi-chen Xu ◽  
Dao-zhong Chen ◽  
Xiao-fu Dai ◽  
Liang-wan Chen
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Femoral Artery ◽  
Femoral Vein ◽  
Vascular Complications ◽  
Minimally Invasive Cardiac Surgery ◽  
Venous Cannulation ◽  
Artery Cannulation ◽  
Short Period

Abstract Background Clinical application of minimally invasive cardiac surgery has increased annually. Cardiopulmonary bypass is established by peripheral cannulation during minimally invasive cardiac surgery. The methodology of peripheral cannulation has unique characteristics, which have associated risks and complications. Few studies have been conducted on this topic. In this study, we focused on complications of peripheral cannulation in totally endoscopic cardiac surgery. Methods Patients who underwent totally endoscopic cardiac surgery with cardiopulmonary bypass established by peripheral cannulation at our institution between January 2019 and June 2020 were reviewed. Specific cannulation strategies and related cannulation complications were noted. Results One hundred forty-eight patients underwent totally endoscopic cardiac surgery. One hundred forty-eight cannulations were performed in the femoral artery and vein, and eleven were performed in the internal jugular vein (combined with the femoral vein). The median size of the femoral artery cannula was 22Fr, and that of the venous canula was 24Fr. One patient died of retroperitoneal haematoma due to femoral artery injury. Three patients had postoperative lower limb oedema. One patient had a postoperative diagnosis of femoral vein thrombosis. Conclusions Different from cannulation in patients with aortic dissection and aneurysms, femoral artery cannulation is safe in totally endoscopic cardiac surgery. Venous cannulation is characterized by a large-bore venous cannula and a short period of use. There are few reports about complications of venous cannulation. The main complication in this study was mechanical injury, and the key to preventing this injury is meticulous manipulation during surgery.

Results after aortic arch repair without cardiopulmonary bypass in high-risk patients

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
M Czerny ◽  
R Gottardi ◽  
D Zimpfer ◽  
M Dorfmeister ◽  
J Holfeld ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Aortic Arch ◽  
High Risk Patients ◽  
Risk Patients ◽  
Aortic Arch Repair
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