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Profound reduction in brain embolization using an endoaortic baffle during bypass in swine
David J Cook1, Kenton J Zehr, Thomas A Orszulak
1Department of Anesthesiology, Mayo Foundation and Mayo Clinic, Rochester, Minnesota, USA. cook.david@mayo.edu
Insights
The Cobra baffle aortic cannula significantly reduced cerebral embolization during cardiopulmonary bypass by 89%. This innovative device shows promise in preventing neurologic injury after cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Biomedical Engineering
Background:
- Cerebral embolization is a significant risk factor for neurologic injury during cardiopulmonary bypass.
- The Cardeon Cobra Catheter, an endoaortic baffle catheter, was investigated for its potential to mitigate this risk.
Purpose of the Study:
- To evaluate the efficacy of the endoaortic baffle catheter in reducing cerebral embolization during cardiopulmonary bypass in a swine model.
- To quantify the reduction in microsphere emboli reaching the brain with baffle deployment.
Main Methods:
- Sixteen swine underwent cardiopulmonary bypass, with eight utilizing the Cobra baffle and eight serving as controls.
- Fluorescent microspheres were administered to induce embolization under normothermic conditions.
- Brains were explanted post-procedure to quantify microsphere deposition in eight distinct regions.
Main Results:
- The Cobra baffle group demonstrated an 89% reduction in total cerebral embolization compared to controls.
- Embolization was significantly reduced in all brain regions analyzed in the baffle group.
- Key physiological parameters remained comparable between the baffle and control groups during the procedure.
Conclusions:
- The Cobra baffle aortic cannula effectively and profoundly reduces cerebral embolization during cardiopulmonary bypass.
- This device holds potential for decreasing the incidence of postcardiac surgical neurologic complications.
Background:
Cerebral embolization during cardiopulmonary bypass is an important cause of neurologic injury. This study determined whether an endoaortic baffle catheter (Cardeon Cobra Catheter; Cardeon Corporation, Cupertino, CA) could substantially reduce cerebral embolization in a swine cardiopulmonary bypass model.
Methods:
Sixteen 60 kg pigs underwent cardiopulmonary bypass; 8 animals with the Cobra baffle (Cardeon Corporation, Cupertino, CA) deployed, and 8 with the same cannula without baffle deployment. The animals were embolized with 72,000 fluorescent microspheres (97 to 100 microm) at normothermia. At the end of the experiment, the brains were removed and microspheres were isolated from eight regions.
Results:
During embolization, the two groups were equivalent with regard to pump flow, mean arterial pressure, temperature, Hgb and PaCO2. Deployment of the Cobra baffle reduced embolization to every brain region. Deployment of the baffle reduced total brain embolization by 89%. There was a mean of 61+/-60 emboli per gram in the control animals and 7+/-24 emboli per gram in those animals in which the baffle was deployed.
Conclusions:
Cerebral embolization is profoundly reduced by use of the Cobra baffle aortic cannula. The application of this device may reduce postcardiac surgical neurologic injury.