title: Cannula design reduces particulate and gaseous emboli during cardiopulmonary bypass for coronary revascularization.
abstract: OBJECTIVE
  The incidence of neurocognitive deficits after coronary bypass surgery remains problematic, with atheroembolism being one of the major causes. External manipulation of aorta and the "sandblasting" effect of the high-velocity perfusion jet can cause dislodgement of atheromatous debris.
  
  
  METHODS
  A new arterial cannula features a tip configuration that diffuses the flow through multiple outlets, providing reduced velocity and shear with one central and three diverted flow streams.
  
  
  RESULTS
  Between March 2007 and July 2008 twenty patients having isolated coronary artery bypass operations were instrumented with an Embolus Detection and Classification transducer. These data were compared to 43 patients from a previous study using similar techniques except for a standard open-tip arterial cannula. Total embolic counts were markedly lower in the new cannula group (20±25 vs 174±378) as were both gaseous (11±15 vs 95±211) and particulate counts (9±11 vs 80±194).
  
  
  CONCLUSIONS
  The select 3D cannula design reduces the sandblasting effect of the perfusion jet and, also, may direct emboli from the heart and cardiopulmonary bypass equipment away from the cerebral circulation.
authors.affiliation: Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA. alata@wfubmc.edu
authors.forename: Adrian L
authors.initials: AL
authors.lastname: Lata
authors.forename: John W
authors.initials: JW
authors.lastname: Hammon
authors.forename: Dwight D
authors.initials: DD
authors.lastname: Deal
authors.forename: David A
authors.initials: DA
authors.lastname: Stump
authors.forename: Edward H
authors.initials: EH
authors.lastname: Kincaid
authors.forename: Neal D
authors.initials: ND
authors.lastname: Kon
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D057785:Catheters; D002560:Cerebrovascular Circulation; D001026:Coronary Artery Bypass / Q000379:methods*; D017700:Embolism, Cholesterol / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies