Lata Adrian L, Hammon John W, Deal Dwight D, Stump David A, Kincaid Edward H, Kon Neal D
Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA.
Perfusion. 2011 May;26(3):239-44. doi: 10.1177/0267659110394905. Epub 2011 Jan 13.
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.
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.
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).
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.
冠状动脉搭桥手术后神经认知功能障碍的发生率仍然是个问题，动脉粥样硬化栓塞是主要原因之一。主动脉的外部操作以及高速灌注射流的“喷砂”效应可导致动脉粥样硬化碎片脱落。
一种新型动脉插管的特点是其尖端结构可使血流通过多个出口扩散，通过一个中心流和三个分流提供降低的流速和剪切力。
在2007年3月至2008年7月期间，20例行单纯冠状动脉搭桥手术的患者使用了栓子检测和分类换能器。将这些数据与之前一项研究中的43例患者进行比较，除了标准的开口尖端动脉插管外，其他技术相似。新插管组的总栓子计数明显更低（20±25对174±378），气态栓子计数（11±15对95±211）和颗粒计数（9±11对80±194）也是如此。
这种经过挑选的三维插管设计降低了灌注射流的喷砂效应，并且还可能将来自心脏和体外循环设备的栓子引离脑循环。
