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Objective: Devices for peripheral venous cannulation have seen significant progress over time. Standard rigid steel cannulas have evolved towards flexible plastic cannulas with wire support that prevent kinking and percutaneous approaches for peripheral cannulations have also been developed during the last twenty years. In contrast to all these rectilinear venous cannula designs, which presents the same cross-sectional area over their entire intravascular path, the smartcanula™ concept of collapsed inserction and expantion in situ is the logical next step for venous cannulation.
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Enrico Ferrari, Piergiorgio Tozzi, Dominique Delay, Giuseppe Siniscalchi, Sandra Bommeli, Ludwig von Segesser.
Cardiovascular Unit, University Hospital CHUV, Lausanne, Switzerland.
Methods: Femoral peripheralvenous cannulation using the longest Smartcanula™ (63 cm.) was established in a series of 30 patients operated between january 2005 and september 2006, undergoing either redo procedures or high risk vascular/cardiovascular interventions. The smartcanula™ performance was assessed comparing the calculated target pump flow and the achieved pump flow.
Results: 30 patients (mean age 64±7 years) have been operated in our institute for complex redo or high risk cardiac and vascular interventions. A peripheral venous canulation via femoral vein have been succesfully established in all patients without complications. The calculated mean target pump flow (2.4 L/min/m²) was 4.44 ± 0.50 L/min. and the mean achieved pump flow during cardiopulmonary bypass was 4.84 ± 0.35 L/min. or 110 % of the target.
Conclusions: Peripheral venous cannulation with the smartcanula™ is safe and feasible in patients undergoin redo or high risk cardiovascular operations. Advantages are the reduced atrial chatter, the reduced kink resistance in situ and an improoved blood drainage despite smaller access orifice size.
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