Cite this post as:
Scott Weingart, MD FCCM. Podcast 123 – Selective Aortic Arch Perfusion (SAAP) with Jim Manning. EMCrit Blog. Published on May 6, 2014. Accessed on August 16th 2022. Available at [https://emcrit.org/emcrit/selective-aortic-arch-perfusion/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: May 6, 2014
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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So when doing SAAP is the blood given through the catheter oxygenated? If so, how?
Yes! A good question and an important point to make clear. The blood (or other oxygen carrier) needs to be oxygenated prior to infusion via the SAAP catheter. SAAP involves infusion directly into the arterial system (aortic arch), so the lungs cannot be used to oxygenate the perfusate before it reaches the heart and brain. We have accomplished this in the laboratory using various oxygenators that are used for cardiopulmonary bypass or ECMO. Such oxygenators are now small enough that they are readily portable. Thanks! Jim
Hello Scott-
I was curious as to how blood continuing the circuit from the periphery is cycled through the body if the aorta is essentially cross-clamped (endovascularly speaking). How is venous blood pooling prevented when continuous transfusion is applied? Thanks!
Nick,
purpose of this is purely short term to perfuse heart and brain. Don’t need to worry about rest of body for this period of time. I think it was mentioned on the podcast that after a few units of blood, goal is to place venous drainage line. If the patient gets, ROSC, I would imagine dropping the balloon on the SAAP to allow partial VA ECMO while you are transitioning to art cannula.