Extracorporeal circulation without external clamping and cannulation of the aorta: transventricular placement of a new multifunctional aortic cannula.
BACKGROUND
Stroke is a devastating outcome of coronary artery bypass grafting (CABG). An atherosclerotic ascending aorta is a major risk factor for plaque detachment during cannulation and external clamping in patients undergoing CABG while on extracorporeal circulation (ECC). To avoid external cannulation and clamping we developed and tested a new multifunctional cannula in a pig model.


METHODS
The cannula has a double-balloon endoclamping function and is placed via the apex of the left ventricle through the aortic valve in the ascending aorta. It has 2 integrated lines for cardioplegic solution and for venting the left ventricle. In this animal model, a single balloon cannula was used because of the short ascending aorta in pigs.


RESULTS
The cannula was placed smoothly and reproducibly with a guide-wire technique. The cardioplegic solution was administered via aortic root perfusion. Weaning from ECC was uneventful, and macroscopic examination did not reveal any damage to the aortic valve.


CONCLUSIONS
This cannula could be used in patients with a severe atherosclerotic ascending aorta. The risk of plaque detachment and stroke during ECC might be reduced.
Scheule
Albertus M
AM
Department of Thoracic, Cardiac and Vascular Surgery, University Hospital Tuebingen, Tuebingen, Germany.
Beierlein
Wolfram
W
Straub
Andreas
A
Ziemer
Gerhard
G
D000818:Animals; D001011:Aorta / Q000601:surgery*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005112:Extracorporeal Circulation / Q000295:instrumentation* / Q000379:methods*; D006352:Heart Ventricles / Q000601:surgery*; D013552:Swine; D016896:Treatment Outcome