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Axillary artery cannulation for aortic and complex cardiac surgery
1Department of Cardiothoracic Surgery, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. levi.bassin@gmail.com
Heart, Lung & Circulation
|September 28, 2010
Summary
Axillary artery cannulation for cardiopulmonary bypass is a safe technique, reducing risks of atheroemboli and malperfusion. This method offers a reliable alternative for complex aortic and cardiac surgeries, minimizing complications.
Area of Science:
- Cardiovascular Surgery
- Vascular Access
- Surgical Techniques
Background:
- Ascending aorta manipulation is avoided with axillary artery cannulation for cardiopulmonary bypass (CPB).
- This technique offers reduced risks of atheroemboli and malperfusion in aortic dissections.
- Facilitates selective antegrade cerebral perfusion (SACP) during hypothermic circulatory arrest (HCA).
Purpose of the Study:
- To evaluate the safety and efficacy of axillary artery cannulation.
- To assess outcomes in patients undergoing aortic and cardiac surgery where the ascending aorta was unapproachable.
Main Methods:
- A single surgeon's 7-year experience with axillary cannulation (side-graft technique) in 116 patients.
- Indications included acute Type A dissection (22), elective aortic surgery (70), CPB before redo sternotomy (5), and porcelain aorta (19).
- Hypothermic circulatory arrest (HCA) was used in 98 cases, with SACP in 18.
Main Results:
- Three postoperative deaths occurred (multi-system failure, stroke, unknown cause).
- 113 patients were discharged well, with no major complications attributed to axillary artery use.
- Low morbidity and mortality rates were observed.
Conclusions:
- Axillary artery cannulation is a safe and reliable technique for arterial inflow.
- It minimizes risks of atheroembolisation and malperfusion.
- Recommended as a standard approach for complex aortic and cardiac surgery.
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