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Ann Thorac Surg 2002;73:198-202
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Profound reduction in brain embolization using an endoaortic baffle during bypass in swine

David J. Cook, MD*a, Kenton J. Zehr, MDb, Thomas A. Orszulak, MDb, Jared M. Slater, BAa,b

a Department of Anesthesiology, Mayo Foundation and Mayo Clinic, Rochester, MN, USA
b Department of Surgery, Division of Cardiovascular Surgery, Mayo Foundation and Mayo Clinic, Rochester, Minnesota 55905, USA

Accepted for publication September 5, 2001.

* Address reprint requests to Dr Cook, Department of Anesthesiology, 200 First St SW, Rochester, MN 55905, USA
e-mail: cook.david{at}mayo.edu

Background. Cerebral embolization during cardiopulmonary bypass is an important cause of neurologic injury. This study determined whether an endoaortic baffle catheter (Cardeon Cobra Catheter; Cardeon Corporation, Cupertino, CA) could substantially reduce cerebral embolization in a swine cardiopulmonary bypass model.

Methods. Sixteen 60 kg pigs underwent cardiopulmonary bypass; 8 animals with the Cobra baffle (Cardeon Corporation, Cupertino, CA) deployed, and 8 with the same cannula without baffle deployment. The animals were embolized with 72,000 fluorescent microspheres (97 to 100 µm) at normothermia. At the end of the experiment, the brains were removed and microspheres were isolated from eight regions.

Results. During embolization, the two groups were equivalent with regard to pump flow, mean arterial pressure, temperature, Hgb and PaCO2. Deployment of the Cobra baffle reduced embolization to every brain region. Deployment of the baffle reduced total brain embolization by 89%. There was a mean of 61 ± 60 emboli per gram in the control animals and 7 ± 24 emboli per gram in those animals in which the baffle was deployed.

Conclusions. Cerebral embolization is profoundly reduced by use of the Cobra baffle aortic cannula. The application of this device may reduce postcardiac surgical neurologic injury.




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