title: Aortic flow patterns resulting from right axillary artery cannulation.
abstract: Right axillary artery (RAA) cannulation is increasingly used in cardiac surgery. Little is known about resulting flow patterns in the aorta. Therefore, flow was visualized and analyzed. A mock circulatory circuit was assembled based on a compliant transparent anatomical silicon aortic model. A RAA cannula was connected to a continuous flow rotary blood pump (RBP), pulsatile heart action was provided by a pneumatic ventricular assist device (PVAD). Peripheral vascular resistance, regional flow and vascular compliance were adjusted to obtain physiological flow and pressure waveforms. Colorants were injected automatically for flow visualization. Five flow distributions with a total flow of 4 l/min were tested (%PVAD:%RBP): 100:0, 75:25, 50:50, 25:75, 0:100. Colorant distribution was assessed using quantitative 2D image processing. Continuous flow from the RAA divided in a retrograde and an antegrade portion. Retro- to antegrade flow ratio increased with increasing RAA-flow. At full RBP support flow was stagnant in the ascending aorta. There were distinct flow patterns between the right- and left-sided supra-aortic branches. At full RBP support retrograde flow was demonstrated in the right carotid and right vertebral arteries. Further studies are needed to confirm and evaluate the described flow patterns.
authors.affiliation: Department of Cardiovascular Surgery, Bern University Hospital, Inselspital, 3010 Bern, Switzerland. sdemertzis@dkf.unibe.ch
authors.forename: Stefanos
authors.initials: S
authors.lastname: Demertzis
authors.forename: Hendrik
authors.initials: H
authors.lastname: Tevaearai
authors.forename: Thierry
authors.initials: T
authors.lastname: Carrel
authors.forename: Stijn
authors.initials: S
authors.lastname: Vandenberghe
mesh_terms: D001011:Aorta / Q000033:anatomy & histology / Q000502:physiology*; D001366:Axillary Artery; D001783:Blood Flow Velocity; D002339:Carotid Arteries / Q000502:physiology; D002406:Catheterization, Peripheral; D003187:Compliance; D006353:Heart-Assist Devices; D006439:Hemodynamics; D018056:Hemorheology; D006801:Humans; D007201:Indicator Dilution Techniques; D008953:Models, Anatomic; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D012825:Silicon; D013997:Time Factors; D014655:Vascular Resistance; D014711:Vertebral Artery / Q000502:physiology
chemical_list: D012825:Silicon