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Related Experiment Videos

Axillary artery cannulation in type a aortic dissection operations.

E Neri1, M Massetti, G Capannini

  • 1Istituto di Chirurgia Cardiovascolar Universitá agli Studi di Siena, Italy.

The Journal of Thoracic and Cardiovascular Surgery
|July 29, 1999
PubMed
Summary

Axillary artery cannulation is a safe and effective alternative for arterial inflow in type A aortic dissection when femoral arteries are compromised. This method ensures successful cardiopulmonary bypass in complex cases.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Femoral artery cannulation is standard for type A aortic dissection.
  • Complications like aneurysms or severe atherosclerosis can preclude femoral artery use.
  • Axillary artery cannulation offers a viable alternative access route.

Purpose of the Study:

  • To evaluate the safety and efficacy of axillary artery cannulation.
  • To assess its use as an alternative inflow site in type A aortic dissection.
  • To determine outcomes in patients with compromised femoral arteries.

Main Methods:

  • Retrospective analysis of 22 patients undergoing type A aortic dissection repair.
  • Axillary artery cannulation used due to femoral artery compromise (dissection, aneurysm, atherosclerosis, occlusive disease).

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  • Deep hypothermic circulatory arrest and open distal anastomosis performed; retrograde cerebral perfusion used in some.

    • Main Results:

    • Successful axillary artery cannulation in all 22 patients.
    • No operative mortality or cerebrovascular accidents related to axillary cannulation.
    • No axillary artery thrombosis, brachial plexus injury, or intraoperative malperfusion.
    • Two late deaths occurred due to non-cannulation-related complications.

    Conclusions:

    • Axillary artery cannulation is a safe and effective alternative for arterial inflow in type A aortic dissection.
    • It is particularly useful when femoral arteries are diseased or compromised.
    • This technique facilitates cardiopulmonary bypass in challenging surgical scenarios.