Related Experiment Video
Updated: Jan 30, 2026
Visualization and Analysis of Pharyngeal Arch Arteries using Whole-mount Immunohistochemistry and 3D Reconstruction
Published on: March 31, 2020
Double-arterial cannulation during aortic arch reconstruction in pediatric patients
Michaela Kreuzer1, Eva Sames-Dolzer1, Peter Benedikt1
1Division of Pediatric Cardiac Surgery Children's Heart Center Linz Linz, Austria.
Insights
A novel double-arterial cannulation technique ensures whole-body perfusion during aortic arch reconstruction in pediatric heart surgery. This safe method enhances perfusion to the brain and lower body, improving surgical outcomes.
Area of Science:
- Congenital Heart Surgery
- Cardiovascular Surgery
- Pediatric Cardiac Anesthesia
Background:
- Aortic arch reconstruction is a complex procedure in pediatric congenital heart surgery.
- Conventional cardiopulmonary bypass methods (deep hypothermic circulatory arrest, antegrade cerebral perfusion) lead to incomplete body perfusion.
- Lack of lower body perfusion poses risks during extended surgical procedures.
Observation:
- A double-arterial cannulation technique was implemented at Children's Heart Center Linz in 2003.
- This technique involves cannulating both the innominate artery and the descending aorta.
- The descending aorta is accessed by opening the left pleural cavity and transecting the inferior pulmonary ligament.
Findings:
- The double-arterial cannulation technique provides continuous perfusion to the brain and the entire lower body.
- Over 450 pediatric cases (uni- and biventricular) have utilized this method without a lethal incident.
- One instance of intraoperative descending aorta lesion was successfully repaired.
Implications:
- This technique offers a simple, safe, and effective alternative for cardiopulmonary bypass during aortic arch reconstruction.
- It potentially reduces complications associated with incomplete organ perfusion in complex pediatric cardiac surgeries.
- The method facilitates improved surgical conditions and patient outcomes in congenital heart defect repairs.
Abstract:
Aortic arch reconstruction is a highly demanding procedure in congenital heart surgery. The 2 conventional options for cardiopulmonary bypass - deep hypothermic circulatory arrest or antegrade cerebral perfusion - both result in lack of perfusion of the entire or lower body. In 2003, the Children's Heart Center Linz started to use a double-arterial cannulation technique for aortic arch reconstructions in order to provide whole body perfusion during the entire operation. Our technique, demonstrated in this video tutorial, is as follows: After inserting an arterial cannula into the innominate artery, followed by venous cannulation, the cardiopulmonary bypass is started. The left pleural cavity is opened directly above the diaphragm. The inferior pulmonary ligament is transected and the descending aorta is then visualized and can be cannulated directly. Both arterial cannulas are linked via a Y-connector. The surgeons in our center have used this method in more than 450 uni- and biventricular newborns and children. There has not been a lethal incident associated with this cannulation technique; one intraoperative lesion of the descending aorta was repaired immediately. Our double-arterial cannulation technique is a simple and safe method for perfusing the brain and the lower parts of the body during aortic arch reconstruction.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:10The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
02:04Fixing Double-strand Breaks