Instructions for use: Ikus - Berlin Heart
Instructions for use: Ikus - Berlin Heart
Instructions for use: Ikus - Berlin Heart
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8 Implantation – Surgical procedure<br />
This chapter describes the product-specific measures during the implantation of an<br />
EXCOR blood pump. The setting of the <strong>Ikus</strong> parameters during and after implantation are<br />
described separately in section “Start up the <strong>Ikus</strong> and set the parameters” on page 31. If<br />
the Driving Unit <strong>Ikus</strong> is brought into the operating room, it should be prepared as<br />
described in section 6.1: “Preparations outside of the operating room”, p. 31.<br />
If not described otherwise, all actions must be per<strong>for</strong>med as in large cardiothoracic<br />
surgery interventions. The implantation is accomplished with the <strong>use</strong> of the HLM,<br />
utilizing standard techniques of cardiothoracic surgery. The implantation may be<br />
per<strong>for</strong>med under induced ventricular fibrillation or on the beating heart. Hypothermia is<br />
not normally required.<br />
Warning!<br />
• Only start the blood pumps after they are completely de-aired!<br />
• Do not touch the pump with pointed or sharp-edged objects (surgical instruments)!<br />
• If a cannula is bent with a flexible metal rein<strong>for</strong>cement to adjust it to the anatomical<br />
conditions: Determine by visual inspection that the blood flow in the cannula is not<br />
restricted.<br />
Recommendation<br />
• For BVAD, per<strong>for</strong>m the anastomosis of the cannulas in the following sequence:<br />
• apical cannulation:<br />
1. apex<br />
2. right atrium<br />
3. pulmonary artery<br />
4. aorta<br />
• atrial cannulation:<br />
1. left atrium<br />
2. right atrium<br />
3. pulmonary artery<br />
4. aorta<br />
8.1 Access<br />
<strong>Instructions</strong><br />
1. Median sternotomy Ensure complete blood dryness.<br />
2. Apply cannulation <strong>for</strong> HLM (bicaval cannulation).<br />
3. Start the cardiopulmonary bypass.<br />
4. Place a vent in the LA if necessary.<br />
8.2 Apex cannula(s)<br />
8.2.1 Anastomosing the apex cannula<br />
Warning!<br />
• During the anastomosis of the apex cannula, ensure the orientation of the cannula head:<br />
The long side of the head should lie parallel to the sidewall of the heart. In this way,<br />
aspiration of the sidewall can be prevented. After introducing the cannula head, its<br />
position can be checked by means of the flow direction arrow on the cannula body<br />
(except <strong>for</strong> apex cannulas C10A-030, C14A-040 and C18A-020): The arrow is aligned with<br />
the long side of the cannula head.<br />
Access<br />
1000002 Rev. 4.9.1 45
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