Document Detail

Trans-hepatic cannulation: a novel approach for placement of a pediatric percutaneous ventricular assist device.
MedLine Citation:
PMID:  16966849     Owner:  NLM     Status:  MEDLINE    
Pediatric ventricular assist device (VAD) use is increasing. The TandemHeart PTVA system is a percutaneous VAD used in adults. Pediatric use is limited by cannula size. Trans-hepatic left atrial (LA) cannulation offers the possibility of shorter, larger-diameter cannulae, but specific requirements for cannula size and flow characteristics need to be developed. We evaluated the feasibility of trans-hepatic cannulation based on patient measurements and bench-top modeling. Two hundred patients admitted to the University of Michigan Pediatric CICU were evaluated. Patients over 14 years and dextrocardiac patients were excluded. The distance from the skin between the 10th and 11th ribs at the mid-axillary line to the left-heart border was measured on x-ray. LA size was measured on echocardiogram. From these measurements, prototype cannulae were fabricated. Benchtop testing of developed cannulae was performed with a pump speed of 8500 RPM and fluid viscosity of 4.0 cP at physiologic atrial and arterial pressures. Inlet pressure and deliverable flows were measured. The proposed design delivered sufficient flow with negative pressures low enough to avoid hemolysis. Trans-hepatic LA cannulation for percutaneous VAD placement is feasible. The shorter distance to the LA and larger hepatic vein size allows design of pediatric-appropriate cannulae with adequate flow rates.
Jeffrey G Gossett; David H J Wang; Douglas E Smith; Eric J Devaney; Thomas R Lloyd
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  52     ISSN:  1058-2916     ISO Abbreviation:  ASAIO J.     Publication Date:    2006 Sep-Oct
Date Detail:
Created Date:  2006-09-12     Completed Date:  2006-12-18     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  517-21     Citation Subset:  IM    
Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan 48109-0204, USA.
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MeSH Terms
Biomedical Engineering
Body Size
Cardiac Surgical Procedures / methods*
Child, Preschool
Heart Atria
Heart Catheterization / instrumentation,  methods*
Heart-Assist Devices*
Hepatic Veins
Infant, Newborn
Grant Support
2-R44-HL078077-02/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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