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Aortic cannula tip dislodgement: A rare complication
Aseem Gargava1, Manjula Sarkar2, Sanjeeta Umbarkar2
1Department of Cardiovascular Anaesthesia, Seth G.S.Medical College and K.E.M. Hospital, Mumbai, Maharashtra; Department of Anaesthesia and Intensive Care, Maulana Azad Medical College, New Delhi, India.
Annals of Cardiac Anaesthesia
|October 28, 2020
Summary
A dislodged metallic tip during cardiac surgery bypass led to aortic migration. Prechecking bypass equipment can prevent such rare, unexpected complications.
Area of Science:
- Cardiovascular Surgery
- Medical Device Safety
- Patient Safety
Background:
- Cardiopulmonary bypass (CPB) circuits in cardiac surgery involve complex tubing and cannulae connected to major vessels.
- Effective CPB requires both surgical skill and vigilance regarding the integrity of disposable circuit components.
- Potential manufacturing defects in CPB disposables can be overlooked during technically demanding procedures.
Observation:
- During aortic decannulation in a mitral valve replacement, a metallic tip detached from a component of the CPB circuit.
- The dislodged metallic tip migrated into the abdominal aorta, posing a significant risk.
Findings:
- This case highlights a rare but serious complication arising from a manufacturing defect in a CPB disposable.
- The incident occurred unexpectedly during the aortic decannulation phase of the procedure.
Implications:
- Systematic pre-operative checks of all cardiopulmonary bypass circuit components by anesthesiologists and perfusionists are crucial.
- Implementing thorough prechecks can mitigate the risk of unforeseen complications related to device defects.
- Enhanced vigilance in inspecting CPB equipment is essential for improving patient safety in cardiac surgery.
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