BVS5000 and AB5000 System Cannulation Guide Rev C

BVS® 5000/AB5000™ Systems Cannulation Guide 1. Select Cannulation Locations Most common locations are listed below Support Side

Location

Cannula Size

Advantage

Left-Inflow

Left Atrium - Interatrial Groove

Most common for left atrial placement

Left-Inflow

Right Superior Pulmonary Vein

Ease of insertion and removal

Left-Inflow

Left Ventricular Apex

Maintains blood flow across prosthetic valves Off-loads left ventricle and LV Chamber

42F - 32F

Left-Outflow

Anterolateral aspect of the Ascending Aorta

N/A

10mm

Right-Inflow

Right Atrium Mid Free Wall

Most common for right-side support

42F - 32F

Right-Outflow

Pulmonary Artery

N/A

10mm

Cannulation Tips:

• Inflow refers to blood from the patient into the VAD • Outflow refers to blood from the VAD back to the patient • Place pledgeted double purse string sutures around the desired cannulation site • Pericardial patches or large Teflon® pledgets and 2-0 or 3-0 polypropylene sutures are recommended

42F - 32F 32F

• Bevel Hemashield® outflow graft at 30 degrees; 3-0 or 4-0 polypropylene sutures are recommended • Consider the use of surgical glue at arterial site to reduce bleeding • Externalize cannula before cannula implantation (see graphic in Step 2 for exit sites)

2. Select Cannula Exit Location Plan for AB5000 Closed Chest Transition

Plan cannula exit sites during BVS Blood Pump implant to facilitate transition to AB5000™ Ventricle

Maintain VAD inflow cannula to left of outflow cannula

RVAD LVAD

3. Cannulation Consideration

AB5000 Connection Guidelines

Assess cannula placement

Cut cannula end perpendicular to the long axis

Apply sterile lubricant to threaded section

Cannula

Cannula Exit Site

• Before closing the chest, record hemodynamics and VAD operating parameters • Approximate chest, and note any changes in hemodynamics and VAD operating parameters • If hemodynamics or VAD operating parameters change, assess cannula positioning • TEE should be used to evaluate cannula inflow with a target velocity of < 400cm/sec. • Cannula should exit patient parallel to each other and spaced ~ 4.5 cm apart to match AB5000 Ventricle • If needed, use supplied tubing extensions • Ensure restraints are properly secured • Use the white threaded cannula restraint marked with a red arrow with the Hemashield ® outflow cannula; use white cannula restraint without red arrow for inflow cannula

LVAD

RVAD

4.5 cm Cannula

(b)

1-2 mm gap when restraint fully seated

Fully seat cannula end to the bottom of barb

(c) (a)

• Apply sterile lubricant (provided) to: (a) threads located on restraint inner diameter; (b) matching threads at base of connector barb; (c) outside of cannula • DO NOT allow lubricant to contact the outside or inside of connector barb or the inside of cannula

ABIOMED 24-HOUR SUPPORT 800-422-8666

For more information on the BVS® 5000 / AB5000TM Systems see: http://www.abiomed.com/clinical_information/ifus_manuals.cfm 0505-2609 Rev. C