Hydrodynamics of aortic arch vessels during perfusion through the right subclavian artery.
BACKGROUND
Performing subclavian artery cannulation in patients with an atherosclerotic ascending aorta or acute aortic dissection is of growing interest. To increase knowledge about pressure and flow distribution in the arch vessels, we investigated the in vitro perfusion characteristics in right subclavian artery cannulation.


METHODS
Pressures and flow rates in the arch vessels of an aortic arch model were measured during perfusion through the right subclavian artery with different geometries and varying flow rates. Flow visualization was performed by laser light.


RESULTS
In normal subclavian artery geometries, pressure and flow showed a significant increase in only the right common carotid artery (8 mm Hg and 25.5 mL/min, respectively, at 5.5 L/min pump flow). In cases of 50% stenosis at the right subclavian artery origin, a reduction of pressure and flow (6 mm Hg and 22.5 mL/min, respectively, at 5.5 L/min pump flow) in the right carotid artery caused by a suction effect was observed.


CONCLUSIONS
Right subclavian artery cannulation provides a valuable alternative for ascending aortic cannulation, enabling nearly balanced arch vessel perfusion. Stenosis at the right subclavian artery origin carries the potential risk of slightly reduced perfusion of the right common carotid artery with questionable clinical relevance.
Gerdes
A
A
Department of Cardiac Surgery, Medical University of Lübeck, Germany.
Joubert-Hübner
E
E
Esders
K
K
Sievers
H H
HH
D000328:Adult; D001013:Aorta, Thoracic / Q000502:physiology*; D017536:Carotid Artery, Common / Q000502:physiology; D006439:Hemodynamics; D006801:Humans; D066298:In Vitro Techniques; D008953:Models, Anatomic; D010477:Perfusion; D013348:Subclavian Artery / Q000502:physiology*