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Updated: Mar 27, 2026
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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
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Right Axillary Artery Cannulation in Aortic Valve Replacement.
Mitsuharu Hosono1, Toshihiko Shibata, Takashi Murakami
1Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan.
Summary
Axillary artery cannulation via a side graft is a safe and effective method for arterial inflow during aortic valve replacement in patients with ascending aortic atherosclerosis. This technique ensures adequate perfusion without complications during cardiopulmonary bypass.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Cardiac Anesthesia
Background:
- Ascending aortic atherosclerotic disease poses challenges for arterial cannulation during aortic valve replacement.
- Traditional cannulation methods may increase risks in patients with severe aortic atherosclerosis.
Purpose of the Study:
- To evaluate the safety and efficacy of axillary artery cannulation via a side graft for arterial inflow.
- To assess outcomes in patients undergoing aortic valve replacement with this technique.
Main Methods:
- Retrospective analysis of 76 patients undergoing aortic valve replacement from 2002-2012.
- Axillary artery cannulation via a side graft was used for arterial inflow.
- Indications included aortic aneurysm, severe atherosclerosis, and re-do surgery.
Main Results:
- Sufficient antegrade aortic flow (2.6 ± 0.1 L/m²) was achieved during cardiopulmonary bypass.
- No additional arterial cannulation was needed for adequate perfusion.
- Two patients experienced permanent perioperative stroke, unrelated to the cannulation site; no graft infections or thrombotic events occurred.
Conclusions:
- Axillary artery cannulation via a side graft is a viable and safe alternative for cardiopulmonary bypass.
- This method is particularly useful in patients with atherosclerotic disease of the ascending aorta undergoing aortic valve replacement.
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