Shani Liran, Cohen Oved, Beckerman Ziv, Nir Rony-Reuven, Bolotin Gil
Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel.
Asian Cardiovasc Thorac Ann. 2014 Jan;22(1):25-30. doi: 10.1177/0218492312467543. Epub 2013 Jul 11.
Stroke after open heart surgery is a major cause of morbidity and mortality. Up to 60% of intraoperative cerebral events are caused by emboli generated by manipulations of the aorta during surgery. This is the first animal study evaluating the safety and efficacy of a novel aortic cannula designed to extract solid and gaseous emboli during cardiac surgery.
Seven domestic pigs were connected to cardiopulmonary bypass using a CardioGard 24F aortic cannula. Three pigs that were cannulated with a standard aortic cannula were defined as controls. Several main flow and suction regimens were carried out. Osseous particles of different sizes were injected into the proximal aorta to simulate emboli.
The CardioGard cannula demonstrated an overall emboli retrieval rate of 77%. A rate of 88.45% was demonstrated during the low-flow regimen used clinically during aortic manipulation. Gaseous and solid emboli were eliminated by suction, as demonstrated by epi-carotid ultrasound. No significant changes were observed in hemodynamic and laboratory parameters.
The CardioGard cannula is as simple to use as a regular commercially available aortic cannula, having a similar safety profile and proven efficacy in capturing intraoperative emboli.
心脏直视手术后的中风是发病和死亡的主要原因。高达60%的术中脑部事件是由手术期间主动脉操作产生的栓子引起的。这是第一项评估一种新型主动脉插管安全性和有效性的动物研究,该插管旨在在心脏手术期间提取固体和气态栓子。
使用CardioGard 24F主动脉插管将7头家猪连接到体外循环。将3头用标准主动脉插管插管的猪定义为对照组。进行了几种主要的流量和抽吸方案。将不同大小的骨颗粒注入主动脉近端以模拟栓子。
CardioGard插管的总体栓子清除率为77%。在主动脉操作期间临床上使用的低流量方案中,清除率为88.45%。颈总动脉超声显示,气态和固体栓子通过抽吸被清除。血流动力学和实验室参数未观察到显著变化。
CardioGard插管与常规市售主动脉插管一样易于使用,具有相似的安全性,并且在捕获术中栓子方面已证实有效。