PBSE Perfusion Practice Exam

Cannula placement during CPB is driven by patient anatomy, the surgical plan, and the perfusion targets to ensure adequate drainage and unobstructed arterial return. The anatomy of the vessels and any prior surgeries or pathologies determine the best access sites and cannula tips to avoid malposition and to achieve reliable drainage. The surgical plan dictates where blood needs to go during the operation and how exposure and reconstruction will be performed, which influences which cannulation configuration and routing are used. Perfusion targets, including body size, metabolic demand, and temperature strategy, guide the size and configuration of the cannulas (for example, dual- or single-stage venous drainage) to meet flow requirements without causing recirculation or excessive pressure loss. This approach explains why cannulation isn’t dictated by surgeon preference alone, nor by oxygenator type alone, and why aiming for correct placement is essential to prevent kinking or obstruction and to maintain stable CPB.