ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2011 February;52(1):105-9

Copyright © 2011 EDIZIONI MINERVA MEDICA

lingua: Inglese

Evaluation of aortic cannula jet lesions in a porcine cardiopulmonary bypass (CPB) model

Schnürer C. ¹, Hager M. ³, Györi G. ², Velik-Salchner C. ², Moser P. L. ³, Laufer G. ⁴, Lorenz I. H. ², Kolbitsch C. ² ✉

¹ Department of Neurosurgery, Vienna Medical University, Vienna, Austria; ² Department of Anaesthesiology and Intensive Care Medicine, Vienna Medical University, Vienna, Austria; ³ Department of Pathology, Vienna Medical University, Vienna, Austria; ⁴ Department of Cardiac Surgery, Innsbruck Medical University (MUI), Innsbruck, Austria

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.