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Axillary vein cannulation, combined with femoral cannulation, offers a feasible cardiopulmonary bypass (CPB) strategy for complex aortic root replacement surgeries. This approach simplifies reoperations and ensures adequate heart decompression without left heart venting.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiopulmonary Bypass Techniques
  • Aortic Surgery

Background:

  • Axillary artery cannulation is a known approach for peripheral cardiopulmonary bypass (CPB).
  • Axillary vein cannulation for CPB is less frequently utilized.
  • Redo aortic root replacement presents surgical challenges, often requiring complex bypass strategies.

Purpose of the Study:

  • To evaluate the efficacy and feasibility of an axillo-axillary and femoro-femoral cardiopulmonary bypass (CPB) strategy.
  • To assess the utility of this combined CPB approach in redo aortic root replacement surgeries.
  • To determine if this strategy simplifies complex aortic reoperations.

Main Methods:

  • Implementation of a combined axillo-axillary and femoro-femoral CPB circuit.
  • Utilized vacuum-assisted drainage for full-flow bypass.
  • Performed redo aortic root replacement with the described CPB strategy.

Main Results:

  • Achieved excellent cardiac decompression without the need for left heart venting.
  • Obtained a comfortable surgical field despite adhesions around the aortic root graft.
  • Demonstrated ease of axillary vessel exposure through a small incision.
  • Facilitated both antegrade and retrograde cerebral protection during circulatory arrest for potential arch procedures.

Conclusions:

  • The axillo-axillary and femoro-femoral CPB strategy is effective and feasible for redo aortic root replacement.
  • This CPB approach simplifies complex aortic reoperations.
  • Axillary vein cannulation is a viable option for CPB in specific redo aortic procedures.