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The Journal of Thoracic and Cardiovascular Surgery, Vol 109, Issue 5 885-890, Copyright © 1995 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
NOTE: The fulltext of this article is not available online.
J. F. Sabik, B. W. Lytle, P. M. McCarthy and D. M. Cosgrove
The increasing number of patients with extensive aortic and peripheral
vascular atherosclerosis or aneurysms who are undergoing cardiac operations
present difficult decisions as to the optimal site of arterial cannulation
for cardiopulmonary bypass. Femoral artery cannulation is the most common
alternative to ascending aortic cannulation, but severe iliofemoral disease
or the danger of atheroemboli caused by retrograde perfusion through an
atherosclerotic or aneurysmal descending aorta may make this approach
impossible or undesirable. We have used axillary artery cannulation for
cardiac operations in 35 patients for indications including severe aortic
atherosclerosis (n = 16), extensive aortic aneurysms (n = 11), and aortic
dissection (n = 8). The cardiac operations performed were coronary artery
bypass grafting (n = 9) aortic valve replacement (n = 1), aortic valve
replacement and coronary artery bypass grafting (n = 5), repair of mitral
valve periprosthetic leak (n = 1), and resection of ascending and/or aortic
arch (n = 19). Deep hypothermia with circulatory arrest was used in 26
patients and retrograde cerebral perfusion in 18. All patients awoke from
the operation and no patient had a cerebrovascular accident. One patient
required axillary artery thrombectomy and one patient had a mild
ipsilateral brachial plexus paresis after the operation. Four patients died
in the hospital. We conclude that axillary artery cannulation is a safe and
effective means of providing antegrade arterial flow during cardiopulmonary
bypass in patients with severe atherosclerotic or aneurysmal disease. This
strategy may lower the prevalence of stroke associated with cardiopulmonary
bypass in these patients.
JOURNAL ARTICLE
Axillary artery: an alternative site of arterial cannulation for patients with extensive aortic and peripheral vascular disease
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinical Foundation F25, OH 44195, USA.
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Z. Galajda, I. Szentkiralyi, and A. Peterffy Brachial artery cannulation in type A aortic dissection operations J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 407 - 409. [Full Text] [PDF]
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E. A. Hessel II and L. H. Edmunds Jr. Extracorporeal Circulation: Perfusion Systems , January 1, 2003; 2(2003): 317 - 338. [Full Text]
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B. W. Lytle Coronary Artery Reoperations , January 1, 2003; 2(2003): 659 - 679. [Full Text]
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D. Spielvogel, M. N. Mathur, and R. B. Griepp Aneurysms of the Aortic Arch , January 1, 2003; 2(2003): 1149 - 1168. [Full Text]
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L. G. Svensson Antegrade perfusion during suspended animation? J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1068 - 1070. [Full Text]
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D. T. Lai, R. C. Robbins, R. S. Mitchell, K. A. Moore, P. E. Oyer, N. E. Shumway, B. A. Reitz, and D. C. Miller Does Profound Hypothermic Circulatory Arrest Improve Survival in Patients With Acute Type A Aortic Dissection? Circulation, September 24, 2002; 106(12_suppl_1): I-218 - I-228. [Abstract] [Full Text] [PDF]
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T. Schachner, K. Vertacnik, G. Laufer, and J. Bonatti Axillary artery cannulation in surgery of the ascending aorta and the aortic arch Eur J Cardiothorac Surg, September 1, 2002; 22(3): 445 - 447. [Abstract] [Full Text] [PDF]
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S. Yavuz, M. T. GoncuGoncu, and T. TurkTurk Axillary artery cannulation for arterial inflow in patients with acute dissection of the ascending aorta Eur J Cardiothorac Surg, August 1, 2002; 22(2): 313 - 315. [Abstract] [Full Text] [PDF]
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O. Tasdemir, A. Saritas, S. Kucuker, M. A. Ozatik, and E. Sener Aortic arch repair with right brachial artery perfusion Ann. Thorac. Surg., June 1, 2002; 73(6): 1837 - 1842. [Abstract] [Full Text] [PDF]
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E. Neri, M. Massetti, L. Barabesi, G. Pula, R. Tassi, T. Toscano, E. Tucci, A. Benvenuti, G. Capannini, F. Miraldi, et al. Extrathoracic cannulation of the left common carotid artery in thoracic aorta operations through a left thoracotomy: Preliminary experience in 26 patients J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 901 - 910. [Abstract] [Full Text] [PDF]
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A. Mazzola, R. Gregorini, C. Villani, and M. Di Eusanio Antegrade cerebral perfusion by axillary artery and left carotid artery inflow at moderate hypothermia Eur J Cardiothorac Surg, May 1, 2002; 21(5): 930 - 931. [Abstract] [Full Text] [PDF]
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I. Fukuda, S. Aikawa, T. Imazuru, and M. Osaka Transapical aortic cannulation for acute aortic dissection with diffuse atherosclerosis J. Thorac. Cardiovasc. Surg., February 1, 2002; 123(2): 369 - 370. [Full Text] [PDF]
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M. Ricci, E. R. Rosenkranz, and T. A. Salerno Surgical strategy for repair of large pseudoaneurysms of the aortic isthmus Eur J Cardiothorac Surg, December 1, 2001; 20(6): 1240 - 1242. [Abstract] [Full Text] [PDF]
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M. G. Licina, R. M. Savage, C. Hearn, and E. J. Kraenzler The Role of Transesophageal Echocardiography in Perfusion Management Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 321 - 334. [Abstract] [PDF]
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K. Yokota, T. Fujii, K. Kimura, T. Toriumi, and A. Sari Life-Threatening Hypoxemic Respiratory Failure After Repair of Acute Type A Aortic Dissection: Successful Treatment with Venoarterial Extracorporeal Life Support Using a Prosthetic Graft Attached to the Right Axillary Artery Anesth. Analg., April 1, 2001; 92(4): 872 - 876. [Full Text] [PDF]
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T. Kazui, N. Washiyama, B. A. H. Muhammad, H. Terada, K. Yamashita, and M. Takinami Improved results of atherosclerotic arch aneurysm operations with a refined technique J. Thorac. Cardiovasc. Surg., March 1, 2001; 121(3): 491 - 499. [Abstract] [Full Text] [PDF]
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L. G. Svensson, J. Libertino, A. Sorcini, S. D. Kaushik, and E. Marinko Minimal-access right atrial exposure for tumor extensions into the inferior vena cava J. Thorac. Cardiovasc. Surg., March 1, 2001; 121(3): 589 - 590. [Full Text] [PDF]
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T. J Velissaris, A. T. Tang, and S. K Ohri Transventricular cannulation of the aorta: a useful technique in acute aortic dissection Perfusion, March 1, 2001; 16(2): 155 - 157. [Abstract] [PDF]
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Y. Moriyama, Y. Iguro, K. Hisatomi, G. Yotsumoto, H. Yamamoto, and R. Toda Thoracic and thoracoabdominal aneurysm repair under deep hypothermia using subclavian arterial perfusion Ann. Thorac. Surg., January 1, 2001; 71(1): 29 - 32. [Abstract] [Full Text] [PDF]
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K. Okada, T. Sueda, K. Orihashi, M. Watari, and O. Ishii An alternative procedure of endovascular stent-graft repair for distal arch aortic aneurysm involving arch vessels J. Thorac. Cardiovasc. Surg., January 1, 2001; 121(1): 0182 - 184. [Full Text] [PDF]
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T. Isomura, H. Suma, T. Horii, T. Sato, T. Kobashi, and H. Kanemitsu Left Subclavian Artery for Graft Inflow in Off-Pump Bypass Asian Cardiovascular and Thoracic Annals, December 1, 2000; 8(4): 322 - 324. [Abstract] [Full Text] [PDF]
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I. Fukuda, S. Gomi, K. Watanabe, and J. Seita Carotid and aortic screening for coronary artery bypass grafting Ann. Thorac. Surg., December 1, 2000; 70(6): 2034 - 2039. [Abstract] [Full Text] [PDF]
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K. Imanaka, S. Kyo, H. Tanabe, H. Ohuchi, H. Asano, and Y. Yokote Fatal intraoperative dissection of the innominate artery due to perfusion through the right axillary artery J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 405 - 406. [Full Text] [PDF]
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T. Katoh, H. Gohra, K. Hamano, H. Takenaka, N. Zempo, and K. Esato Right axillary cannulation in the left thoracotomy for thoracic aortic aneurysm Ann. Thorac. Surg., July 1, 2000; 70(1): 311 - 313. [Abstract] [Full Text] [PDF]
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A. Gerdes, E. Joubert-Hubner, K. Esders, and H.-H. Sievers Hydrodynamics of aortic arch vessels during perfusion through the right subclavian artery Ann. Thorac. Surg., May 1, 2000; 69(5): 1425 - 1430. [Abstract] [Full Text] [PDF]
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J. D. Whitlark, S. M. Goldman, and F. P. Sutter Axillary artery cannulation in acute ascending aortic dissections Ann. Thorac. Surg., April 1, 2000; 69(4): 1127 - 1128. [Abstract] [Full Text] [PDF]
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