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Quantification of visceral perfusion and impact of femoral cannulation: in vitro model of aortic dissection

Authors
 Woon Heo  ;  Gyu-Han Lee  ;  Tae-Hoon Kim  ;  Youngjin Lee  ;  Hyungkyu Huh  ;  Hojin Ha  ;  Suk-Won Song  ;  Kyung-Jong Yoo 
Citation
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol.62(1) : ezab508, 2022-06 
Journal Title
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
ISSN
 1010-7940 
Issue Date
2022-06
MeSH
Aneurysm, Dissecting* / surgery ; Axillary Artery* ; Cardiopulmonary Bypass / methods ; Catheterization / methods ; Femoral Artery ; Humans ; Perfusion
Keywords
Aortic dissection ; Cardiovascular models ; Haemodynamics ; Perfusion
Abstract
Objectives: We aimed to simulate blood flow at an aortic dissection in an in vitro vascular model and assess the impact of the cannulation method on visceral perfusion.

Methods: An aortic-dissection model with an acrylic aortic wall and silicone intimal flap was developed to study visceral perfusion under various cannulation conditions. The primary tear was placed in the proximal descending aorta and the re-entry site in the left common iliac artery. A cardiovascular pump was used to reproduce a normal pulsatile aortic flow and a steady cannulation flow. Axillary and axillary plus femoral cannulation were compared at flow rates of 3-7 l/min. Haemodynamics were analysed by using four-dimensional flow magnetic resonance imaging.

Results: Axillary cannulation (AC) was found to collapse the true lumen at the coeliac and superior mesentery arteries, while combined axillary and femoral cannulation did not change the size of the true lumen. Combined axillary and femoral cannulation resulted in a larger visceral flow than did AC alone. When axillary plus femoral cannulation was used, the visceral flow increased by 125% at 3 l/min, by 89% at 4 l/min, by 67% at 5 L/min, by 98% at 6 l/min and by 101% at 7 l/min, respectively, compared to those with the AC only.

Conclusions: Our model was useful to understanding the haemodynamics in aortic dissection. In this specific condition, we confirmed that the intimal flap motion can partially block blood flow to the coeliac and superior mesenteric arteries and that additional femoral cannulation can increase visceral perfusion.
Full Text
https://academic.oup.com/ejcts/article/62/1/ezab508/6469048?login=true
DOI
10.1093/ejcts/ezab508
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3987-0057
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Heo, Woon(허운)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191546
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