AV Flow Cannula: A New Device for Antegrade Selective Cerebral Perfusion

CTSNet, Inc. Media 2020 May 7: https://doi.org/10.25373/ctsnet.12249644.v1

The novelty of this device is the possibility of a guidewire introduction using the Seldinger technique.

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AV cannula is a silicone cannula with a malleable steel shaft. It has been specifically designed in order to be introduced directly into supra-aortic vessels (SAV) and not just from the ostia of the vessel. This cannula is similar to existing cannulas with an inflatable balloon at the tip in order to seal the vessel proximally while perfusing distally.

The novelty of this device is the possibility of a guidewire introduction using the Seldinger technique. A 5/0 prolene (possibly pledget reinforced) suture is placed on the innominate artery and on the left common carotid artery wall.

Antegrade selective cerebral perfusion has become the preferred choice for brain protection during aortic arch surgery. It was first described in 1989-1991 by Kazui and Bachet (2, 3, 4). Since then, in order to perform antegrade selective cerebral perfusion (ASCP), cannulas have been introduced directly into the ostia of the SAV after institution of hypothermic circulatory arrest (HCA) and opening the aortic arch.
The authors describe a different surgical technique with a new type of cannula for ASCP. This cannula, called AV Flow, has been designed to be introduced in the supra-aortic vessels directly using a standard guidewire technique. The AV Flow can also be introduced from the ostia of the supra-aortic vessels if preferred.