NDLI: Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases.

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Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases.

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Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Von Segesser, Ludwig K. Ferrari, Enrico Delay, Dominique Maunz, Olaf Horisberger, Judith Tozzi, Piergorgio
Description	Country affiliation: Switzerland Author Affiliation: von Segesser LK ( Department of Cardio-Vascular Surgery, CHUV, Lausanne, Switzerland. ludwig.von-segesser@chuv.ch)
Abstract	OBJECTIVE: Assess the performance of self-expanding venous cannulas for routine use in open-heart surgery. METHODS: Prospective study in 100 unselected consecutive patients undergoing open-heart surgery with either remote or central smart venous cannulation. RESULTS: The study focuses on the 76 consecutive adult patients (mean age 59.2+/-17.3 years; 60 males, 16 females) undergoing surgical procedures with total cardiopulmonary bypass for either valve procedures (42/76 patients=55.3%), ascending aorta and arch repair (20/76 patients=26.3%), coronary artery revascularization (13/76 patients=17.1%) or other procedures (11/76 patients=14.5%) with 14/76 patients (18.4%) undergoing redo surgery and 6/76 patients (7.9%) undergoing small access surgery. The mean pump flow achieved by gravity drainage alone accounted for 5.0+/-0.6l/min (=114% of target) in the entire study population (n=76) as compared to the calculated, theoretical pump flow of 4.4+/-0.5l/min (p<0.0001). For the femoral cannulation sub-group (n=35) pump flow achieved by gravity drainage alone accounted for 4.9+/-0.6l/min (=114% of target) as compared to the calculated theoretical pump flow of 4.3+/-0.4l/min (p<0.0001). The corresponding numbers for trans-subclavian cannulation (n=7) are 5.2+/-0.5l/min (111%) for the pump flow achieved by gravity drainage as compared to the theoretical target flow of 4.7+/-0.4l/min. For the central cannulation sub-group (n=34) mean flow achieved by gravity drainage with a self-expanding venous cannula accounted for 5.1+/-0.7l/min (=116% of target) as compared to the calculated theoretical flow of 4.4+/-0.6l/min (p<0.0001). CONCLUSION: Full or more than target flow was achieved in 97% of the patients studied undergoing CPB with self-expanding venous cannulas and gravity drainage. Remote venous cannulation with self-expanding cannulas provides similar flows as central cannulation. Augmentation of venous return is no longer necessary.
File Format	HTM / HTML
ISSN	10107940
e-ISSN	1873734X
Journal	European Journal of Cardio-Thoracic Surgery
Issue Number	3
Volume Number	34
Language	English
Publisher	Oxford University Press
Publisher Date	2008-09-01
Publisher Place	Germany
Access Restriction	Open
Subject Keyword	Discipline Cardiology__semicolon__surgery Cardiopulmonary Bypass Instrumentation Catheterization, Central Venous Catheterization, Peripheral Cardiac Surgical Procedures Equipment Design Femoral Vein Prospective Studies Reoperation Subclavian Vein Evaluation Studies
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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