Abstract
ObjectivesDetermine if shortening the covered section of a self-expanding bidirectional arterial cannula, can enhance retrograde flow and thus reduce the risk of lower limb ischemia.MethodsOutlet pressure vs flow rate was determined for three cannulas types: a 15F self-expanding bidirectional cannula having a covered section of 90 mm, the same cannula but with a shorter covered section of 60 mm, and a Biomedicus cannula as control. The performances of all the cannulas were compared using a computerized flow-bench with calibrated sensors and a centrifugal pump. Water retrograde flow was determined using a tank timer technique. Anterograde and retrograde flow rate versus outlet pressure were determined at six different pump speed.ResultsFor each of the six pump speed, both bidirectional cannulas, 60-mm covered and 90-mm covered respectively, showed higher performance than Biomedicus cannula control, as demonstrated by higher flow rate and lower pressure. We also observed that for the bidirectional cannula with shorter covered section, i.e. 60 mm coverage, provides enhanced performance as compared to a 90-mm coverage. Finally, the flow rate and the corresponding pressure can be consistently measured by our experimental set-up with low variability.ConclusionsThe new configuration of a shorter covered section in a bidirectional self-expanding cannula design, may present an opportunity to overcome lower leg ischemia during extra-corporal life support with long term peripheral cannulation.
Highlights
Femoral arterial cannulation for arterial inflow is essential for cardiac surgical procedures, as well as for extracorporal life support (ECLS) and extra-corporal membrane oxygenation (ECMO)
Improved anterograde flow rate to each revolution per minute for both self-expanding bidirectional cannulas 60, was on average 15 and 9% respectively compared to the standard control cannula (Table 1)
Comparison of retrograde flow rate versus pressure Results clearly show that the 60 mm covered access section bidirectional cannula provided higher retrograde flow rate as compared to the 90 mm covered
Summary
Femoral arterial cannulation for arterial inflow is essential for cardiac surgical procedures, as well as for extracorporal life support (ECLS) and extra-corporal membrane oxygenation (ECMO). The longer the femoral artery perfusion, the higher the risk of serious problems for distal perfusion. An eventual obstruction of the access vessel by traditional rectilinear cannulas design may cause irreversible hindrances such as amputation or even death. Several authors have stated an important risk of lower limb. Collateral blood flow is responsible for the viability of the lower limb. Incidence of lower limb ischemia is often related to deprived flow rate, leading to an obligation for fasciotomy or even amputation. A number of techniques have been proposed to prevent this potentially devastating complication, including the use of a downstream femoral perfusion catheter [1, 4,5,6] or an end-to-side femoral
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
