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PubMed1998

Fluoroscopy and selective angiography of left ventricular assist system inflow cannula as a method of detecting cannula entrapment.

Left ventricular assist systems have become an important tool as a bridge to cardiac transplantation. Malfunction of these devices often leads to clinical and hemodynamic deterioration. One potential complication is the obstruction of the inflow cannula secondary to remodeling of the left ventricular cavity. We report two cases where fluoroscopy and selective angiography were used to visualize the orientation and obstruction of the inflow cannula when echocardiographic findings were indeterminant.

Adult↗
PubMedDate not supplied

Complicated cannula insertions and cannula dislodgments associated with extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation therapy remains a life saving modality for neonates with cardiopulmonary disease that is unresponsive to conventional therapy. Vital to its success is the insertion and maintenance of appropriately sized vascular cannulas. Problematic insertion and accidental dislodgments can be life threatening. To determine the treatment and outcome of these complications, a survey of participating Extracorporeal Life Support Organization centers was undertaken. Venous cannulation complications (13 patients) were due to inadequate vein size or tearing during initial attempts at cannulation. Proximal and alternative site cannulation were used. Difficult arterial cannulations (seven patients) were most often due to creation of an intimal flap that was corrected by proximal cannulation of the same vessel. The 10 cases of accidental dislodgment were most often associated with changes in position. Despite copious hemorrhage in many instances, 6 of 10 patients survived with intact neurologic status. Methods for dealing with these life threatening cannula related complications are described.

Cardiovascular Diseases↗
PubMed2003

[In vivo and in vitro evaluation of inflow cannula of left ventricular assist].

OBJECTIVE: To develop an inflow cannula of left ventricular assist implanted by blood vessel. METHODS: The maximum inflow and properties against folding of 8 sorts of cannulae were measured in mimic extracorporeal circulation appliances and canines. RESULTS: The maximum flow of the cannula increased, as the inner diameter became greater (P < 0.01) compared with each group. The maximum flow rate was (1.82 +/- 0.03) L/min, (2.44 +/- 0.03) L/min, (3.02 +/- 0.04) L/min, (3.31 +/- 0.03) L/min respectively for polyvinyl cannulae with wall thickness of 0.5 mm (PV 0.5 cannula) and inner diameter of 3 mm, 4 mm, 5 mm, 6 mm; (1.83 +/- 0.03) L/min, (3.07 +/- 0.04) L/min respectively for the polyvinyl chloride cannula with wall thickness of 1.0 mm imbedded by spring wire (PVCSW 1.0) and inner diameter of 3 mm and 5 mm; (1.82 +/- 0.02) L/min, 1.84 +/- 0.02 L/min for strengthened polyvinyl cannula with wall thickness of 0.8 mm (SPV 0.8) and inner diameter of 3 mm and polyvinyl cannula with wall thickness of 1.0 mm (PV 1.0 cannula) of inner diameter of 3 mm. There was no remarked statistical difference in vitro maximum flow among the four cannulae of 3 mm inner diameter in vitro. PVCSW 1.0 was showed the best antifolding property, PV 1.0 cannula good and SPV 0.8 and PV 0.5 unsatisfactory in properties against fold. There was no significant statistical difference between in vivo and in vitro maximum flow for PVCSW 1.0 and PV 1.0 cannulae of 3 mm inner diameter. But for SPV 0.8 and PV 0.5 cannulae of 3 mm inner diameter, there was a significant difference between in vivo and in vitro. CONCLUSIONS: PV 0.5 cannula and SPV 0.8 cannula are not suitable to clinical use. PV 1.0 cannula can be used in clinics. PVCSW 1.0 cannula is fully qualified for inflow conduit of left ventricular assist in surgery.

Animals↗