FIND YOUR IDEAL CARDIOPLEGIA CANNULAE - … · FINDING THE RIGHT CANNULAE. You’re facing a nearly endless range of procedural scenarios and ever-increasing variability in the

FIND YOUR IDEAL CARDIOPLEGIA CANNULAEDELIVERING MYOCARDIAL PROTECTION

FINDING THE RIGHT CANNULAE You’re facing a nearly endless range of procedural scenarios and ever-increasing variability in the operating room, requiring sets of cardioplegia cannulae which offer incredible breadth and depth. More than ever, your cardiovascular team is tasked with delivering a high level of myocardial protection for standard and minimally invasive cases.

WHAT IS YOUR IDEAL CARDIOPLEGIA STRATEGY?

DLP™ Silicone RCSP Cannulae with Manual-Inflate Cuff Silicone manual-inflate cuffs with pressure monitoring lines feature a smooth cuff for easy placement or ridged cuff for enhanced retention. Choose from standard sized or elongated for enhanced retention and occlusion of middle cardiac vein.

DLP™ Silicone RCSP Cannulae with Auto-Inflate Cuff Silicone auto-inflate cuffs offer the convenience of cuff inflation without the need for a syringe. The unique flow-through design allows cardioplegia to circulate through the cuff before exiting the cannula tip.

DLP™ Aortic Root Cannulae Aortic root pressure monitoring and left heart venting. All DLP aortic root cannulae can be used to aspirate emboli as well as to administer cardioplegia.

“ Simultaneous delivery revealed the most consistent results and the best perfusion of the anterior left ventricle and right ventricle in comparison to antegrade or retrograde routes.”6

Using retrograde cardioplegia in conjunction with antegrade delivery conserves time and reduces mortality.7-10

Important Safety Information Care and caution should be taken when inserting the needle to prevent perforation of the back wall of the aorta. Care and caution should be taken to avoid damage to vessels and cardiac tissue during cannulation or other cardiac surgery procedures. Additional care and caution may be necessary due to the unique adaptations required for minimally invasive cardiac surgery. Extreme caution should be exercised while introducing the cannula into the coronary sinus. Do not force the cannula into the coronary sinus as this may cause vessel damage. Do not over inflate the balloon. Caution: Federal Law (USA) restricts this device to sale or on the order of a physician.

RETROGRADE

ANTEGRADE

MiAR™ Cannulae12.25 in (31 cm) overall length

Flanged Standard Tip and Flow-Guard™ Introducer

11012L 12 ga (9 Fr)

11014L 14 ga (7 Fr)

(10 per carton)

DLP™ Dual Lumen Aortic Root Cannulae with Vent Line3.25 in (8.3 cm) overall length

Standard Tip

30401 12 ga (9 Fr)

DLP™ Aortic Root Cannulae 2.5 in (6.4 cm) overall length

Flanged Standard Tip and Standard Introducer

10218 18 ga (4 Fr) white tip and clear flange

12218 18 ga (4 Fr) blue one-piece tip and flange

(20 per carton)

5.75 in (14.6 cm) overall length

Slotted Long Tip and Standard Introducer

10112 12 ga (9 Fr)

10114 14 ga (7 Fr)

Long Tip and Standard Introducer

(20 per carton)


Slotted Long Tip and Standard Introducer

20112 12 ga (9 Fr)

20114 14 ga (7 Fr)

Flanged Long Tip and Standard Introducer

20114WF 14 ga (7 Fr)

20114WF 14 ga (7 Fr) with side holes

(20 per carton)

DLP™ Aortic Root Cannulae with Vent Line 5.5 in (14.0 cm) overall length

Flanged Stardard Tip and Standard Introducer

20009 9 ga (11 Fr)

20012 12 ga (9 Fr)

20012S 12 ga (9 Fr) with two clamps

20014 14 ga (7 Fr)

20014L 14 ga (7 Fr) 8 in (20.3 cm) vent line

20016 16 ga (5 Fr)


21012 12 ga (9 Fr)

21014 14 ga (7 Fr)

(20 per carton)

DLP™ Silicone Coronary Artery Ostial Cannulae 10 in (25.4 cm) overall length

30315 15 Fr (5.0 mm) bulb

30317 17 Fr (5.7 mm) bulb

30320 20 Fr (6.7 mm) bulb

(10 per carton)

DLP™ Cardioplegia NeedlesPediatric - 6.5 in (16.5 cm) overall length

Tip Length 1/4 in (0.64 cm) with Hub Stop

11316 16 ga (5 Fr)

(20 per carton)

Adult –10 in (25.4 cm) overall length

Tip Length 5/8 in (1.59 cm) with 4 Side Holes and Flange Stop

10313 13 ga (8 Fr)

(20 per carton)


Flanged Pressure Monitoring Tip and Standard Introducer

23009 9 ga (11 Fr)

(20 per carton)


Flanged Pressure Monitoring Tip and Standard Introducer

24009 9 ga (11 Fr)

(20 per carton)


Flanged Stardard Tip and Standard Introducer

10009 9 ga (11 Fr)

10012 12 ga (9 Fr)

10014 14 ga (7 Fr)

10016 16 ga (5 Fr)

10018 18 ga (4 Fr)


11012 12 ga (9 Fr)

11014 14 ga (7 Fr)

(20 per carton)

Important Safety Information Antegrade Cannulae: Care should be taken when inserting the needle to prevent perforation of the back wall of the aorta. Care and caution should be taken to avoid damage to vessels and cardiac tissue during cannulation or other cardiac surgery procedures. Additional care and caution may be necessary due to the unique adaptations required for minimally invasive techniques. For a listing of indications, contraindications, precautions, and warnings, please refer to the Instructions for Use. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

ANTEGRADE CANNULAEORDERING INFORMATION

DLP™ Coronary Artery Ostial Cannulae 6 in (15.2 cm) overall length

Basket Tip

30010 10 Fr (3.3 mm)

30012 12 Fr (4.0 mm)

20014 14 Fr (4.7 mm)

(20 per carton)

Spherical Tip

30011 (20 per carton)

Soft, Concave Tip


Soft, Convex Tip


DLP™ High Flow Coronary Artery Ostial Cannulae 7.5 in (19.1 cm) overall length

90° Angle Tip

30110 10 Fr (3.3 mm)

30112 12 Fr (4.0 mm)

20114 14 Fr (4.7 mm)

90° Angle Soft Silicone Tip

30155 10 Fr (3.3 mm)

45° Angle Tip

30212 12 Fr (4.0 mm)

45° Angle Soft Silicone Tip

30255 10 Fr (3.3 mm)

(10 per carton)

RETROGRADE CANNULAEORDERING INFORMATION

Important Safety Information Retrograde Cannulae: Extreme caution should be exercised while introducing the cannula into the coronary sinus. Do not force the cannula into the coronary sinus as this may cause vessel damage. Do not over inflate the balloon. Additional care and caution may be necessary due to the unique adaptations required for minimally invasive techniques. Due to limitations of direct visualization during minimally invasive techniques, echocardiographic or fluoroscopic imaging is recommended. Care and caution should be taken to avoid damage to vessels and cardiac tissue during cannulation or other cardiac surgery procedures. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

DLP™ Silicone RCSP Cannulae with Manual-Inflate Cuff (continued) 12.5 in (31.8 cm) overall length

Ridged Cuff, Wirewound Body, and Integral Stopcock

94913 13 Fr (4.3 mm) guidewire stylet

94913L

13 Fr (4.3 mm) guidewire stylet and 6 in (15.2 cm) pressure monitoring and inflation line


9496515 Fr (5.0 mm) guidewire stylet with Tru-Touch™ handle

94975 15 Fr (5.0 mm) solid stylet with Tru-Touch™ handle

(10 per carton)

DLP™ Silicone RCSP Cannulae with Auto-Inflate Cuff 12.5 in (31.8 cm) overall length

Smooth Preformed Cuff and Wirewound Body

94315T 15 Fr (5.0 mm) solid stylet

94415T 15 Fr (5.0 mm) guidewire stylet



Ridged Preformed Cuff, Wirewound Body, and Integral Stopcock


(10 per carton)

DLP™ PVC RCSP Cannulae with Auto-Inflate Cuff 10 in (25.4 cm) overall length

Smooth Preformed Cuff, Short Fluted, Bullet Nosed Tip, and Integral Stopcock

94885K 15 Fr (5.0 mm) solid stylet with Tru-Touch™ handle

(10 per carton)

11 in (27.9 cm) overall length

Smooth Preformed Cuff, Multi-Port Tip, and Integral Stopcock



(10 per carton)

12 in (30.5 cm) length

Smooth Preformed Cuff, Short Fluted, Bullet Nosed Tip, and Integral Stopcock



(10 per carton)

12.5 in (31.8 cm) length

Smooth Preformed Cuff, Fluted, Bullet Nosed Tip, and Integral Stopcock


Ridged Preformed Silicone Cuff, Short Fluted, Bullet Nosed Tip,

and Integral Stopcock


(10 per carton)

Gundry™ Silicone RCSP Cannulae with Manual-Inflate Cuff 9 in (22.9 cm) overall length

Smooth Cuff and Wirewound Body


(4 per carton)

MiRCSP™ Cannulae 12.5 in (31.8 cm) overall length

Tip Deflecting Thoracotomy

94113 TDT 13 Fr manual-inflate cuff

94533 TDT 13 Fr auto-inflate cuff

(2 per carton)


Smooth Cuff, Wirewound Body, and Integral Stopcock


(10 per carton)


(4 per carton)


(10 per carton)



(10 per carton)

DLP™ Silicone RCSP Cannulae with Manual-Inflate Cuff 9 in (22.9 cm) overall length


94010 10 Fr (3.3 mm) no stylet

(4 per carton)


Smooth Cuff, Non-Wirewound Body, and Integral Stopcock

94006 6 Fr (2.0 mm) no stylet


(4 per carton)



94215T 15 Fr (5.0 mm) solid stylet

(10 per carton)

Smooth Cuff, Wirewound Body, and Integral Stopcock


(10 per carton)

Elongated Cuff, Wirewound Body, and Integral Stopcock

94625 15 Fr (5.0 mm) solid stylet


(10 per carton)

FIND YOUR IDEAL SOLUTION FOR STANDARD CASESYour standard case is anything but standard — and we know it. Medtronic offers the largest portfolio of cardioplegia cannulae to treat your patients as they present with ever varying disease states and anatomies.

DLP™ High Flow Coronary Artery Ostial Cannulae Hand-held or clamped placement options allow infusion directly into the coronary arteries. Clinical settings may include, AVR, ascending aortic arch resection, or other surgical procedures where the ascending aortic arch is incised.

ANTEGRADE

ANTEGRADE

ANTEGRADE

DLP™ Silicone Coronary Artery Ostial Cannulae Intracoronary application offers an alternate cannulation strategy and improves visualization of the aortic root.

DLP™ Dual Lumen Aortic Root Cannulae with Vent Line Dual lumen tip with vent line allows simultaneous administration of cardioplegia delivery and left heart venting, so there’s no need to discontinue cardioplegia delivery while aspirating air.

Important Safety Information For a listing of indications, contraindications, precautions, and warnings, please refer to the Instructions for Use. Care and caution should be taken to avoid damage to vessels and cardiac tissue during cannulation or other cardiac surgery procedures. Care and caution should be taken when inserting the needle to prevent perforation of the back wall of the aorta. Extreme caution should be exercised while introducing the cannula into the coronary sinus as this may cause vessel damage. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

The elongated balloon limits a shunting effect Clinical studies suggest that standard coronary sinus perfusion techniques allow a portion of the retrograde cardioplegia to be shunted away from the capillary vessels, depriving them of nutritive cardioplegia flow.2 By using a cannulae with an elongated balloon to block the middle cardiac vein (through which the undesired shunting takes place), cardioplegia is directed to the capillary beds, providing for improved myocardial distribution in the free wall of the left ventricle and a more uniform temperature gradient.2

RETROGRADE

DLP™ Silicone RCSP Cannulae with Elongated Manual-Inflate Cuff

LONG BALLOON

ANTEGRADE

RETROGRADE

MAXIMIZE PROTECTION FOR YOUR MINIMALLY INVASIVE CASESJust because your operation is minimally invasive doesn’t mean you should provide less protection. Complex MICS procedures and those with anticipated longer cross clamp times do require enhanced myocardial protection.3 Medtronic provides options specifically designed to help you maneuver in your minimally invasive incisions.

MiAR™ Cannulae (Minimally Invasive Aortic Root) Notably long, at 12.25 inches — and just right for facilitating placement through a mini-sternotomy or right thoracotomy. The MiAR maintains hemostasis and allows retraction of the needle point into a rigid fitting after placement of the cannulae.

MiRCSP™ Cannulae (Minimally Invasive Coronary Sinus Perfusion) Provides enhanced visibility and manueverability4 to aid insertion in MICS procedures where a standard retrograde cannula is difficult to insert.3

When you’re making important decisions, keep in mind that the basic tenets of myocardial protection apply to both standard and MICS procedures.5

Important Safety Information Extreme caution should be exercised while introducing the cannulae into the coronary sinus. Do not force the cannulae into the coronary sinus as this may cause vessel damage. Additional care and caution may be necessary due to the unique adaptations required for minimally invasive techniques. Due to limitations of direct visualization during minimally invasive techniques, echocardiographic or fluoroscopic imaging is recommended. Care and caution should be taken to avoid damage to vessels and cardiac tissue during cannulation or other cardiac surgery procedures. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

Continuous retrograde cardioplegia is particularly useful for coronary reoperations and provides adequate myocardial protection when combined with antegrade delivery.10 The simultaneous technique of combined cardioplegia keeps the heart decompressed and vented, washes atheroemboli from veins and arteries, and provides uniform myocardial protection.10 Clinical discovery can help you look across the many options available. There may be more than one way, indeed.

IMPROVE YOUR MYOCARDIAL PROTECTION.

Antegrade and retrograde cardioplegia work together to protect the heart in more than one way.3, 7, 11

RETROGRADE

ANTEGRADE

FINDING THE RIGHT CARDIOPLEGIA SCHEMEWhether a continuous or intermittment cardioplegia approach or a cold, warm, or normothermic delivery, your cannulation scheme includes many considerations.

By accessing the largest portfolio of cardioplegia cannulae today, your decisions can be based on more options, so you can treat more patients.

At Medtronic, we’re working for you, bringing you the tools and technologies that you’ve asked for. Find your ideal cardioplegia cannulae today.

CONSIDER ALL YOUR OPTIONSA specific cannulation scheme must be created for each operation.1

For more information, contact your local Medtronic Cannula Products Representative. U.S. Customer Service: (800) 328-1357. Not all products are approved in every geography.

References

1 Balaram, Sandhya K. et al. Minimally invasive perfusion techniques. In: Mongero LB, Beck JR eds. On Bypass: Advanced Perfusion Techniques. Totowa, NJ. Humana Press. 2008:141-170.

2 Bezon E, Barra JA, Mondine P, Karaterki A. Retrograde cold blood cardioplegia. Obliteration of the posterior interventricular vein in the coronary sinus improves cooling of the left ventricle posterior wall. Cardiovasc Surg. December 1997;5(6):620-625.

3 Pretre R, Turina M. Myocardial protection in minimally invasive valvular surgery In: Salerno TA, Ricci M, eds. Myocardial Protection. Elmsford, NY. Blackwell Futura. 2004:174-180.

4 Medtronic data on file.

5 Chitwood WR Jr, Wixon CL, Elbeery JR, et al. Minimally invasive cardiac operation: adapting cardioprotective strategies. Ann Thorac Surg. November 1999;68(5):1974-1977.

6 Cohen G, Borger MA, Weisel RD, Rao V. Intraoperative myocardial protection: current trends and future perspectives. Ann Thorac Sur. November 1999;68(5):1995-2001.

7 Buckberg GD, Beyersdorf F, Allen BS, Robertson JM. Integrated myocardial management: background and initial application. J Card Surg. January 1995;10(1):68-89.

8 Borger MA, Rao V, Weisel RD, et al. Reoperative coronary bypass surgery: effect of patent grafts and retrograde cardioplegia. J Thorac Cardiovasc Surg. January 2001;121(1):83-90.

9 Ascione R, Suleiman SM, Angelini GD. Retrograde hot-shot cardioplegia in patients with left ventricular hypertrophy undergoing aortic valve replacement. Ann Thorac Surg. February 2008;85(2):454-458.

10 Fazel S, Borger MA, Weisel RD, et al. Myocardial protection in reoperative coronary artery bypass grafting. J Card Surg. July-August 2004;19(4):291-295.

11 Scholl FG, Drinkwater DC. Antegrade, retrograde, or both. In: Salerno TA, Ricci M, eds. Myocardial Protection. Elmsford, NY. Blackwell Futura. 2004:82-87.

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710 Medtronic ParkwayMinneapolis, MN 55432-5604USAToll-free in USA: 800.633.8766 Worldwide: +1.763.514.4000

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LifeLine CardioVascular Technical Support Tel: (877) 526-7890 Tel: (763) 526-7890 Fax: (763) 526-7888 [email protected]

Documents

FIND YOUR IDEAL CARDIOPLEGIA CANNULAE - … · FINDING THE RIGHT CANNULAE. You’re facing a nearly endless range of procedural scenarios and ever-increasing variability in the