3, 5, 9
When a dual-lumen cannula underperforms, suspect insertion depth before device failure. Confirm depth echocardiographically before considering exchange.
Cannula designs against each other, and correct versus incorrect positioning
DOI 10.1038/s41598-023-34655-1
Computational fluid dynamics simulation at 2-6 L/min, with varied rotation and insertion depth
In silico only. Patient-averaged anatomy, single cannula size, no patient outcomes. Does not capture patient movement, volume state or RV function.
Both designs achieved recirculation fraction below 7% at correct position - essentially zero at 2 and 4 L/min, rising to 3.0-6.2% at 6 L/min - with near-identical pressure-drop curves. Rotation to plus or minus 60 degrees changed recirculation little (2.4-3.1%). Short insertion depth raised recirculation to 31.2-44.6% at all flow rates; long insertion depth caused 24.0% recirculation only at maximum flow. Caval pressures of 16.2-23.9 mmHg at low flows; high-velocity jets above 5 m/s at 4 L/min with shear stress above 413 Pa.
Computational model of a patient-averaged right atrium and venae cavae; two commercial bicaval dual-lumen cannulae (Avalon Elite and MC3 Crescent) scaled to 27 Fr