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Published on: March 27, 2018
Axillary artery in cardiopulmonary bypass: indications and results
Fernando A Atik1, Cristiano N Faber, Ricardo B Corso
1Instituto de Cardiologia do Distrito Federal, Fundação Universitária de Cardiologia, Brasília, DF, Brazil. atikf@mac.com
Objectives:
To determine indications and results of axillary artery cannulation for cardiopulmonary bypass.
Methods:
From January 2005 through December 2008, axillary artery cannulation was used in 48 patients. Mean age was 62 +/- 11 years and 33 (69%) patients were males. Axillary artery was approached by infraclavicular incision and the cannula introduced in a 8 millimeter Dacron side graft.
Results:
Indications were calcified aorta (N=18, 38%), aortic dissection (N=15, 31%), ascending and/or aortic arch aneurysm (N=11, 23%) and prior to reoperative median sternotomy (N=4, 8%). Changes in intraoperative planning occurred most often in patients with calcified aorta (100% versus 10%, P<0.0001) than in patients with other indications, which follow their preoperative plan. Cardiopulmonary bypass (deep hypothermic circulatory arrest in 55% and conventional in the remaining) was uneventfully conducted in all patients but one (success rate 98%) due to undiagnosed inominate artery stenosis. Local complication was lymphatic drainage in three (6.2%) patients.
Conclusions:
Axillary artery is an alternative cannulation site in patients unsuitable to aortic cannulation. The type of indication may determine intraoperative changes in surgical planning.
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