Gerald S Weinstein, MD The Annals of Thoracic Surgery

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Presentation transcript:

Left hemispheric strokes in coronary surgery: implications for end-hole aortic cannulas Gerald S Weinstein, MD The Annals of Thoracic Surgery Volume 71, Issue 1, Pages 128-132 (January 2001) DOI: 10.1016/S0003-4975(00)02208-6

Fig 1 Location of all 51 strokes (number is shown in parentheses). The Annals of Thoracic Surgery 2001 71, 128-132DOI: (10.1016/S0003-4975(00)02208-6)

Fig 2 Location of the 24 major perioperative strokes by hemisphere. The Annals of Thoracic Surgery 2001 71, 128-132DOI: (10.1016/S0003-4975(00)02208-6)

Fig 3 End-hole aortic cannulas direct a high-velocity jet at the orifices of the left carotid and left subclavian arteries, sparing the innominate, which may explain the preponderance of left hemispheric perioperative strokes. (Reprinted with permission of Terumo Cardiovascular Systems Corp.) The Annals of Thoracic Surgery 2001 71, 128-132DOI: (10.1016/S0003-4975(00)02208-6)

Fig 4 Typical end-hole aortic cannula produces a single, high-velocity jet at more than 400 cm/s. (Reprinted with permission of Baxter Research Medical, Inc.) The Annals of Thoracic Surgery 2001 71, 128-132DOI: (10.1016/S0003-4975(00)02208-6)

Fig 5 The Sarns Soft-flow aortic cannula is plugged at the end and has four side holes which produce four low-velocity streams at approximately 100 cm/s, which is similar to normal aortic systolic velocity of 80 cm/s. (Reprinted with permission of Terumo Cardiovascular Systems Corp.) The Annals of Thoracic Surgery 2001 71, 128-132DOI: (10.1016/S0003-4975(00)02208-6)

Fig 6 The Baxter RMI Dispersion aortic cannula produces flow in the shape of a fan, rather than a high-velocity jet. (Reprinted with permission of Baxter Research Medical, Inc.) The Annals of Thoracic Surgery 2001 71, 128-132DOI: (10.1016/S0003-4975(00)02208-6)