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Small access (30F) clinical central venous smart cannulation: is it adequate?
Ludwig K von Segesser1, Piergiorgio Tozzi, Enrico Riccardo Ferrari
1Department of Cardio-vascular Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, CCV, BH 10-275, CH-1011, Lausanne, Switzerland. ludwig.von-segesser@chuv.ch
Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
Summary
The 36F smartcannula provides adequate venous drainage for cardiopulmonary bypass (CPB) using gravity alone, comparable to the 45F model. This smaller cannula requires a smaller access orifice, demonstrating its efficiency in CPB procedures.
Area of Science:
- Cardiovascular Surgery
- Medical Device Engineering
Background:
- Cardiopulmonary bypass (CPB) requires effective venous drainage.
- Cannula size and design impact drainage efficiency and invasiveness.
Purpose of the Study:
- To compare the performance of 45F and 36F smartcannulas for venous drainage during CPB using gravity alone.
- To evaluate the efficacy of a smaller diameter cannula in achieving adequate blood flow.
Main Methods:
- Twenty patients undergoing CPB were randomized to receive either a 45F or 36F smartcannula for venous drainage.
- The smartcannula was inserted into the inferior vena cava and expanded in situ.
- Venous drainage capacity was assessed by pump flow rates and water balance during CPB.
Main Results:
- Both 45F and 36F smartcannulas achieved comparable pump flows (approximately 8% above target) with no significant difference in water balance.
- The 36F cannula required a significantly smaller access orifice (78.5 mm²) compared to the 45F cannula (132 mm²).
- Patient demographics including age, body weight, and body surface area (BSA) were similar between the groups.
Conclusions:
- The 36F smartcannula demonstrates sufficient venous drainage capacity by gravity alone for full CPB in adults with BSA up to 2.2 m².
- Its design, featuring an 'open' wall and reduced wall thickness, allows for effective drainage with a smaller insertion site.
- The 36F smartcannula offers a less invasive option for venous drainage in CPB without compromising flow rates.
