title: Evaluation of aortic cannula jet lesions in a porcine cardiopulmonary bypass (CPB) model.
abstract: In cardiosurgery patients atherosclerotic debris displaced from the cannulation site but also from the opposite aortic wall by the "sandblast-like" effect of the high-pressure jet emanating from the cannula is a potential source of intraoperative arterial embolization and consequently postoperative neurologic dysfunction. The present study examined the extent to which shear stress exerted on the intact aortic intima by an aortic cannula jet stream can cause endothelial lesions that promote thrombogenesis and consequently thrombembolism. A single-stream, straight-tip aortic cannula was used in a porcine cardiopulmonary bypass (CPB) model. Following a 120-minute CPB pump run, a 60-minute stabilization period was allowed before sacrificing the pigs (N.=40) for histological evaluation of the ascending aorta and the brain. Opposite the cannulation site endothelial lesions (diameter: 3.81±1.3 mm; depth: 0.017±0.003 mm) were present in 22.5% (9/40) of aortic specimens. Cerebral thrombembolic lesions were not found. The present study showed that single-stream, straight-tip aortic cannulas caused jet lesions of the formerly intact aortic endothelium opposite the cannulation site in 22.5% of cases in a porcine CPB model.
authors.affiliation: Department of Neurosurgery, Vienna Medical University, Vienna, Austria. christian.schnuerer@meduniwien.ac.at
authors.forename: C
authors.initials: C
authors.lastname: Schnürer
authors.forename: M
authors.initials: M
authors.lastname: Hager
authors.forename: G
authors.initials: G
authors.lastname: Györi
authors.forename: C
authors.initials: C
authors.lastname: Velik-Salchner
authors.forename: P L
authors.initials: PL
authors.lastname: Moser
authors.forename: G
authors.initials: G
authors.lastname: Laufer
authors.forename: I H
authors.initials: IH
authors.lastname: Lorenz
authors.forename: C
authors.initials: C
authors.lastname: Kolbitsch
mesh_terms: D000818:Animals; D001011:Aorta / Q000293:injuries* / Q000473:pathology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation; D057785:Catheters; D004730:Endothelium, Vascular / Q000293:injuries* / Q000473:pathology; D023421:Models, Animal; D013314:Stress, Mechanical; D013552:Swine; D013997:Time Factors; D017539:Tunica Intima / Q000293:injuries* / Q000473:pathology; D057772:Vascular System Injuries / Q000209:etiology* / Q000473:pathology