4.3 Article

Design optimization of bidirectional arterial perfusion cannula

Journal

JOURNAL OF CARDIOTHORACIC SURGERY
Volume 16, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s13019-021-01500-3

Keywords

Virtually wall-less cannula; Bidirectional cannula; Arterial cannulation; ECMO; ECLS; Leg ischemia

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The study found that shortening the covered section of a self-expanding bidirectional arterial cannula can enhance flow rate and reduce pressure, compared to a longer covered section. The results demonstrated that the cannula with a shorter covered section had better performance, effectively lowering the risk of lower limb ischemia.
Objectives Determine 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. Methods Outlet 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. Results For 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. Conclusions The 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.

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