Pulmonary artery to distal bypass for surgery on the descending thoracic aorta

A variety of extracorporeal techniques have been described in surgery of the descending thoracic and thoracoabdominal aorta. We describe an operative approach involving the cannulation of the pulmonary artery for venous drainage in 12 patients undergoing descending thoracic aortic surgery. In-hospital mortality was 17%; there were no in-hospital deaths for elective cases. There were no cases of post-operative paraplegia. Cannulation of the pulmonary artery is a safe and technically simple means of providing venous drainage during cardiopulmonary bypass in aortic surgery. This is an effective approach to distal perfusion in aortic surgery that is associated with excellent flows and avoids cannulating the left side of the heart.