Document Detail


The impact of aortic/subclavian outflow cannulation for cardiopulmonary bypass and cardiac support: a computational fluid dynamics study.
MedLine Citation:
PMID:  19775264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Approximately 100 000 cases of oxygen deficiency in the brain occur during cardiopulmonary bypass (CPB) procedures each year. In particular, perfusion of the carotid and vertebral arteries is affected. The position of the outflow cannula influences the blood flow to the cardiovascular system and thus end organ perfusion. Traditionally, the cannula returns blood into the ascending aorta. But some surgeons prefer cannulation to the right subclavian artery. A computational fluid dynamics study was initially undertaken for both approaches. The vessel model was created from real computed tomography/magnetic resonance imaging data of young healthy patients. The simulations were run with usual CPB conditions. The flow distribution for different cannula positions in the aorta was studied, as well as the impact of the cannula tip distance to vertebral artery for the subclavian position. The study presents a fast method of analyzing the flow distribution in the cardiovascular system, and can be adapted for other applications such as ventricular assist device support. It revealed that two effects cause the loss of perfusion seen clinically: a vortex under the brachiocephalic trunk and low pressure regions near the cannula jet. The results suggest that cannulation to the subclavian artery is preferred if the cannula tip is sufficiently far away from the branch of the vertebral artery. For the aortic positions, however, the cannula should be injected from the left body side.
Authors:
Tim A S Kaufmann; Marcus Hormes; Marco Laumen; Daniel L Timms; Torsten Linde; Thomas Schmitz-Rode; Anton Moritz; Omer Dzemali; Ulrich Steinseifer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Artificial organs     Volume:  33     ISSN:  1525-1594     ISO Abbreviation:  Artif Organs     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-24     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  727-32     Citation Subset:  IM    
Affiliation:
Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany. kaufmann@hia.rwth-aachen.de
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MeSH Terms
Descriptor/Qualifier:
Aorta / anatomy & histology,  physiology*
Aortography / methods
Blood Flow Velocity
Cardiopulmonary Bypass* / adverse effects
Catheterization, Peripheral*
Computer Simulation*
Heart-Assist Devices*
Hemodynamics*
Humans
Magnetic Resonance Angiography
Models, Cardiovascular*
Regional Blood Flow
Subclavian Artery / anatomy & histology,  physiology*
Tomography, X-Ray Computed

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


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