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Use of axillary cannulation for simultaneous endo-occlusion and antegrade perfusion during minimally invasive surgery
Robert Saeid Farivar1, Joss D Fernandez
1Department of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Carver College of Medicine, Iowa City, IA 52242, USA. robert-farivar@uiowa.edu
Objective:
We aimed to develop an antegrade arterial perfusion method that would allow a single suture line on the heart.
Methods:
Using an 8-mm Dacron graft sewn to the right axillary artery, we performed antegrade arterial flow and simultaneous endo-occlusion, as well as the delivery of antegrade cardioplegia.
Results:
Five patients underwent right axillary antegrade flow, with intention to use axillary endo-occlusion. There were no deaths, axillary artery injuries, or conversions to sternotomy. One patient who had a small (6 mm) axillary artery required femoral arterial balloon placement with axillary arterial flow. When using a 100-mm endoballoon, transesophageal echo alone is suitable for placement of the endoballoon. All patients are alive and doing well at least 1 year after surgery.
Conclusions:
The right axillary artery is a suitable conduit for simultaneous endo-occlusion, antegrade flow, and antegrade cardioplegia delivery during mitral valve surgery.
