A comparison of flow gradients across disposable arterial perfusion cannulas

Five-hundred members of The Society of Thoracic Surgeons were canvassed to discover which cannulas are currently used for open-heart surgical procedures in adults; 120 surgeons responded. The mean arterial line pressure produced by 29 disposable arterial perfusion cannulas (size range, 16F to 30F) at flow rates of 1 to 5 liters per minute was compared. A roller pump with perfusion tubing 95 mm (0.75 inch) in diameter was used with water as the test solution. Line pressures in these cannulas ranged from 22.4 +/- 2.30 (standard deviation) to 271.0 +/- 6.60 mm Hg at 5 L/min. Four 24F cannulas had gradients of less than 55 mm Hg at a flow rate of 5 L/min, and 6 cannulas--4 of which were 22F and 2, 24F--had gradients higher than 150 mm Hg at 5 L/min. A number of cannulas kinked easily, and these showed marked increases in line pressure. The following results were obtained from this study: (1) a wide range of line pressures was observed in disposable arterial perfusion cannulas currently in clinical use; (2) some cannulas currently used for cardiopulmonary bypass in adults generated excessive line pressure; and (3) both material and design affect function, with some designs being safer than others. Cardiac surgeons should base the choice of an arterial perfusion cannula on the best performance and safest design available to avoid cannula-related problems at operation.