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Technical problems and complications of axillary artery cannulation
Thomas Schachner1, Johann Nagiller, Anne Zimmer
1Department of Cardiac Surgery, Innsbruck University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria. thomas.schachner@uibk.ac.at
Summary
Axillary artery cannulation for cardiopulmonary bypass presents technical challenges, with the sidegraft technique showing fewer complications than direct cannulation, especially in aortic dissections.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Access
Background:
- Axillary artery cannulation is a common approach for cardiopulmonary bypass, particularly in aortic dissection cases.
- Increased utilization has highlighted associated technical difficulties and complications.
Purpose of the Study:
- To describe the technical problems and complications encountered with axillary artery cannulation.
- To compare outcomes between direct cannulation and sidegraft techniques.
Main Methods:
- Retrospective analysis of 65 patients undergoing axillary artery cannulation.
- Indications included acute aortic dissection (57%), chronic dissection (8%), aneurysms (18%), and others.
- Comparison of direct cannulation versus sidegraft technique outcomes.
Main Results:
- Overall technical problems and complications occurred in 14% of patients.
- The sidegraft technique had 0% arterial damage/dissection, compared to 9% for direct cannulation (P=n.s.).
- Malperfusion in aortic dissections was significantly lower with direct cannulation (0%) versus sidegraft (20%) (P=0.016).
Conclusions:
- Axillary artery cannulation is a viable alternative, but vigilance for technical issues is crucial.
- Different complications arise with direct versus sidegraft techniques.
- Surgeon preference currently dictates the choice of axillary cannulation technique.