Hydrodynamical comparison of aortic arch cannulae.

The high velocity of blood flow exiting aortic arch cannulae may erode atherosclerotic material from the aortic intima causing non-cardiac complications such as stroke, multiple organ failure and death. Five 24 Fr cannulae from the Sarns product line (straight open tip, angled open tip with and without round side holes, straight and angled closed tip with four rectangular, lateral side holes), and a flexible cannula used at the University Hospital of Gent (straight open tip) are compared in an in vitro steady flow setup, to study the spatial velocity distribution inside the jet. The setup consists of an ultrasound Doppler velocimeter, mounted opposite to the cannula tip in an outflow reservoir. An elevated supply tank supplies steady flow of 1.3 L/min of water. Exit forces at various distances from the tip are calculated by integrating the assessed velocity profiles. The pressure drop across the cannula tip is measured using fluid filled pressure transducers. The four sidehole design provides the lowest exit velocity (0.85 versus 1.08 m/s) and force per jet (0.03 vs 0.15-0.20 N). The round sideholes are useless as less than 1% of the flow is directed through them. Furthermore, the use of angled tip cannulae is suggested because the force exerted on the aortic wall decreases the more the angle of incidence of the jet deviates from 90 degrees. Pressure drop is the lowest for the 4 side hole design and highest for the open tip and increases when an angled tip is used.