Profound reduction in brain embolization using an endoaortic baffle during bypass in swine.
BACKGROUND
Cerebral embolization during cardiopulmonary bypass is an important cause of neurologic injury. This study determined whether an endoaortic baffle catheter (Cardeon Cobra Catheter; Cardeon Corporation, Cupertino, CA) could substantially reduce cerebral embolization in a swine cardiopulmonary bypass model.


METHODS
Sixteen 60 kg pigs underwent cardiopulmonary bypass; 8 animals with the Cobra baffle (Cardeon Corporation, Cupertino, CA) deployed, and 8 with the same cannula without baffle deployment. The animals were embolized with 72,000 fluorescent microspheres (97 to 100 microm) at normothermia. At the end of the experiment, the brains were removed and microspheres were isolated from eight regions.


RESULTS
During embolization, the two groups were equivalent with regard to pump flow, mean arterial pressure, temperature, Hgb and PaCO2. Deployment of the Cobra baffle reduced embolization to every brain region. Deployment of the baffle reduced total brain embolization by 89%. There was a mean of 61+/-60 emboli per gram in the control animals and 7+/-24 emboli per gram in those animals in which the baffle was deployed.


CONCLUSIONS
Cerebral embolization is profoundly reduced by use of the Cobra baffle aortic cannula. The application of this device may reduce postcardiac surgical neurologic injury.
Cook
David J
DJ
Department of Anesthesiology, Mayo Foundation and Mayo Clinic, Rochester, Minnesota, USA. cook.david@mayo.edu
Zehr
Kenton J
KJ
Orszulak
Thomas A
TA
Slater
Jared M
JM
D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002404:Catheterization; D005374:Filtration; D020766:Intracranial Embolism / Q000517:prevention & control*; D008863:Microspheres; D023421:Models, Animal; D013552:Swine