What is a negative aspect of femoral reinfusion cannulation during DHCA?

The selection of retrograde flow through a diseased aorta as a negative aspect of femoral reinfusion cannulation during deep hypothermic circulatory arrest (DHCA) is grounded in the physiological implications this presents. When reinfusing blood through the femoral cannula, there exists the possibility that the flow may not proceed in an optimal manner, especially if there are atheromatous plaques or significant stenosis in the aorta.

In such cases, this retrograde flow can lead to inadequate perfusion of vital organs and tissues, as the inflow may meet resistance or become turbulent. Additionally, this retrograde infusion can exacerbate existing aortic disease, potentially leading to embolization of plaque material and creating complications downstream that jeopardize organ function.

This scenario highlights the importance of assessing the aortic condition prior to utilizing femoral reinfusion, as the integrity and health of the vascular structures involved can significantly impact patient outcomes during DHCA. This awareness is crucial for perfusionists when planning and executing cardiopulmonary bypass strategies.