CVP Cannulation Techniques and Circulatory Support Flashcards

What is the most common site for arterial cannulation in standard cardiopulmonary bypass?

Answer: Ascending aorta

The ascending aorta is the preferred arterial cannulation site for standard CPB because it provides direct, high-flow access to the systemic arterial circulation.

When is femoral artery cannulation preferred over ascending aortic cannulation?

Answer: In cases of aortic dissection, severe aortic calcification, or redo sternotomy

Femoral cannulation provides alternative arterial inflow when the ascending aorta is unsafe due to dissection, heavy calcification, or inaccessibility during redo sternotomy.

What is the primary risk of cannulating or clamping a severely calcified ('porcelain') aorta?

Answer: Systemic embolization of atherosclerotic debris causing stroke or organ ischemia

Manipulating a heavily calcified aorta can dislodge atheromatous plaques that embolize to the brain, kidneys, or other end organs, causing stroke or ischemia.

Which venous cannulation technique uses a single cannula positioned in the right atrium with drainage holes extending into the inferior vena cava?

Answer: Single two-stage venous cannula

A two-stage venous cannula has drainage holes at the tip (draining the IVC) and mid-section (draining the right atrium), providing adequate venous return through one cannulation site.

For which type of cardiac procedure is bicaval cannulation with separate SVC and IVC cannulas specifically required?

Answer: Open right heart procedures such as tricuspid valve repair or ASD closure

Bicaval cannulation isolates both venae cavae with snares when the right atrium must be opened, keeping the right heart bloodless and dry for tricuspid valve or septal defect repair.

What is the primary purpose of an aortic root vent placed during CPB?

Answer: To decompress the left heart and remove accumulated air before cross-clamp removal

The aortic root vent removes air from the aortic root and decompresses the left-sided heart during bypass, preventing air embolism when cardiac ejection resumes.