Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input

Abstract Cardiopulmonary bypass (CPB) is a standard technique for cardiac surgery, but comes with the risk of severe neurological complications (e.g. stroke) caused by embolisms and/or reduced cerebral perfusion. We report on an aortic cannula prototype design (optiCAN) with helical outflow and jet-...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kristin Hugenroth, Ralf Borchardt, Philine Ritter, Sascha Groß-Hardt, Bart Meyns, Tom Verbelen, Ulrich Steinseifer, Tim A. S. Kaufmann, Ulrich M. Engelmann
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bfcccda03dbb4c2c899750442f7295d2
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:bfcccda03dbb4c2c899750442f7295d2
record_format	dspace
spelling	oai:doaj.org-article:bfcccda03dbb4c2c899750442f7295d22021-12-02T17:08:36ZOptimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input10.1038/s41598-021-96397-22045-2322https://doaj.org/article/bfcccda03dbb4c2c899750442f7295d22021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96397-2https://doaj.org/toc/2045-2322Abstract Cardiopulmonary bypass (CPB) is a standard technique for cardiac surgery, but comes with the risk of severe neurological complications (e.g. stroke) caused by embolisms and/or reduced cerebral perfusion. We report on an aortic cannula prototype design (optiCAN) with helical outflow and jet-splitting dispersion tip that could reduce the risk of embolic events and restores cerebral perfusion to 97.5% of physiological flow during CPB in vivo, whereas a commercial curved-tip cannula yields 74.6%. In further in vitro comparison, pressure loss and hemolysis parameters of optiCAN remain unaffected. Results are reproducibly confirmed in silico for an exemplary human aortic anatomy via computational fluid dynamics (CFD) simulations. Based on CFD simulations, we firstly show that optiCAN design improves aortic root washout, which reduces the risk of thromboembolism. Secondly, we identify regions of the aortic intima with increased risk of plaque release by correlating areas of enhanced plaque growth and high wall shear stresses (WSS). From this we propose another easy-to-manufacture cannula design (opti2CAN) that decreases areas burdened by high WSS, while preserving physiological cerebral flow and favorable hemodynamics. With this novel cannula design, we propose a cannulation option to reduce neurological complications and the prevalence of stroke in high-risk patients after CPB.Kristin HugenrothRalf BorchardtPhiline RitterSascha Groß-HardtBart MeynsTom VerbelenUlrich SteinseiferTim A. S. KaufmannUlrich M. EngelmannNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kristin Hugenroth Ralf Borchardt Philine Ritter Sascha Groß-Hardt Bart Meyns Tom Verbelen Ulrich Steinseifer Tim A. S. Kaufmann Ulrich M. Engelmann Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
description	Abstract Cardiopulmonary bypass (CPB) is a standard technique for cardiac surgery, but comes with the risk of severe neurological complications (e.g. stroke) caused by embolisms and/or reduced cerebral perfusion. We report on an aortic cannula prototype design (optiCAN) with helical outflow and jet-splitting dispersion tip that could reduce the risk of embolic events and restores cerebral perfusion to 97.5% of physiological flow during CPB in vivo, whereas a commercial curved-tip cannula yields 74.6%. In further in vitro comparison, pressure loss and hemolysis parameters of optiCAN remain unaffected. Results are reproducibly confirmed in silico for an exemplary human aortic anatomy via computational fluid dynamics (CFD) simulations. Based on CFD simulations, we firstly show that optiCAN design improves aortic root washout, which reduces the risk of thromboembolism. Secondly, we identify regions of the aortic intima with increased risk of plaque release by correlating areas of enhanced plaque growth and high wall shear stresses (WSS). From this we propose another easy-to-manufacture cannula design (opti2CAN) that decreases areas burdened by high WSS, while preserving physiological cerebral flow and favorable hemodynamics. With this novel cannula design, we propose a cannulation option to reduce neurological complications and the prevalence of stroke in high-risk patients after CPB.
format	article
author	Kristin Hugenroth Ralf Borchardt Philine Ritter Sascha Groß-Hardt Bart Meyns Tom Verbelen Ulrich Steinseifer Tim A. S. Kaufmann Ulrich M. Engelmann
author_facet	Kristin Hugenroth Ralf Borchardt Philine Ritter Sascha Groß-Hardt Bart Meyns Tom Verbelen Ulrich Steinseifer Tim A. S. Kaufmann Ulrich M. Engelmann
author_sort	Kristin Hugenroth
title	Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
title_short	Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
title_full	Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
title_fullStr	Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
title_full_unstemmed	Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
title_sort	optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bfcccda03dbb4c2c899750442f7295d2
work_keys_str_mv	AT kristinhugenroth optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT ralfborchardt optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT philineritter optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT saschagroßhardt optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT bartmeyns optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT tomverbelen optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT ulrichsteinseifer optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT timaskaufmann optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput AT ulrichmengelmann optimizingcerebralperfusionandhemodynamicsduringcardiopulmonarybypassthroughcannuladesigncombininginsilicoinvitroandinvivoinput
_version_	1718381581518766080

Optimizing cerebral perfusion and hemodynamics during cardiopulmonary bypass through cannula design combining in silico, in vitro and in vivo input

Ejemplares similares