Brain protection by using innominate artery cannulation during aortic arch surgery

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Aneurysms of the ascending aorta and aortic arch require complex surgical repair.
• Cardiopulmonary bypass and cerebral protection are critical during these procedures.
• Cannulation strategies significantly impact surgical outcomes and patient safety.

Purpose of the Study:

• To evaluate the efficacy and safety of innominate artery cannulation (IAC) for aortic aneurysm surgery.
• To assess the adequacy of blood flow and cerebral perfusion using IAC.
• To determine the complication rate associated with IAC in this patient cohort.

Main Methods:

• Retrospective analysis of 68 patients undergoing ascending aorta or aortic arch aneurysm repair.
• Innominate artery cannulation (IAC) utilized through the primary sternotomy incision.
• Assessment of cardiopulmonary bypass flow rates during cooling and re-warming.
• Evaluation of cerebral perfusion during hypothermic circulatory arrest.

Main Results:

• IAC achieved adequate blood flow during cardiopulmonary bypass (cooling and re-warming phases).
• Sufficient antegrade cerebral perfusion was maintained during hypothermic circulatory arrest.
• No technique-related complications were observed in the studied patient group.

Conclusions:

• Innominate artery cannulation is a simple and effective method for aortic aneurysm surgery.
• IAC facilitates adequate perfusion and bypass, ensuring patient safety.
• This technique presents a viable alternative for cannulation in complex aortic procedures.