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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.


JOURNAL ARTICLE

Axillary artery: an alternative site of arterial cannulation for patients with extensive aortic and peripheral vascular disease

J. F. Sabik, B. W. Lytle, P. M. McCarthy and D. M. Cosgrove
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinical Foundation F25, OH 44195, USA.

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.


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J. Thorac. Cardiovasc. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Eur. J. Cardiothorac. Surg.Home page
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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SEMIN CARDIOTHORAC VASC ANESTHHome page
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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Anesth. Analg.Home page
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.
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J. Thorac. Cardiovasc. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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PerfusionHome page
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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Ann. Thorac. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Asian Cardiovasc. Thorac. Ann.Home page
T. Isomura, H. Suma, T. Horii, T. Sato, T. Kobashi, H. Kanemitsu, T. Isomura, H. Suma, T. Horii, T. Sato, et al.
Left Subclavian Artery for Graft Inflow in Off-Pump Bypass
Asian Cardiovasc Thorac Ann, December 1, 2000; 8(4): 322 - 324.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
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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J. Thorac. Cardiovasc. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
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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Ann. Thorac. Surg.Home page
Y. R. Baribeau and B. M. Westbrook
Axillary cannulation
Ann. Thorac. Surg., January 1, 2000; 69(1): 317 - 317.
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J. Thorac. Cardiovasc. Surg.Home page
A. M. Gillinov, J. F. Sabik, B. W. Lytle, and D. M. Cosgrove
Axillary artery cannulation
J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1153 - 1153.
[Full Text]


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CirculationHome page
J. Ye, G. Dai, L. N. Ryner, P. Kozlowski, L. Yang, R. Summers, J. Sun, T. A. Salerno, R. L. Somorjai, and R. Deslauriers
Unilateral Antegrade Cerebral Perfusion Through the Right Axillary Artery Provides Uniform Flow Distribution to Both Hemispheres of the Brain : A Magnetic Resonance and Histopathological Study in Pigs
Circulation, November 9, 1999; 100 (2009): II-309 - II-315.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
K. Yasuura, Y. Takagi, Y. Oohara, and Y. Takami
TOTAL BODY RETROGRADE PERFUSION DURING OPERATIONS ON THE DESCENDING THORACIC AORTA
J. Thorac. Cardiovasc. Surg., September 1, 1999; 118(3): 559 - 561.
[Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
E. Neri, M. Massetti, G. Capannini, E. Carone, E. Tucci, F. Diciolla, E. Prifti, and C. Sassi
AXILLARY ARTERY CANNULATION IN TYPE A AORTIC DISSECTION OPERATIONS
J. Thorac. Cardiovasc. Surg., August 1, 1999; 118(2): 324 - 329.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
R. G. Leyh, C. Bartels, A. Notzold, and H.-H. Sievers
Management of porcelain aorta during coronary artery bypass grafting
Ann. Thorac. Surg., April 1, 1999; 67(4): 986 - 988.
[Abstract] [Full Text] [PDF]


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Eur. J. Cardiothorac. Surg.Home page
S. Westaby, T. Katsumata, and G. Vaccari
Arch and descending aortic aneurysms: influence of perfusion technique on neurological outcome
Eur. J. Cardiothorac. Surg., February 1, 1999; 15(2): 180 - 185.
[Abstract] [Full Text] [PDF]


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Eur. J. Cardiothorac. Surg.Home page
J. Bonatti, R. Ladurner, H. Hangler, and F. Katzgraber
Anatomical studies concerning technical feasibility of minimally invasive axillocoronary bypass grafting
Eur. J. Cardiothorac. Surg., October 1, 1998; 14(suppl_1): S71 - S75.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
Y. R. Baribeau, B. M. Westbrook, D. C. Charlesworth, and C. T. Maloney
Arterial inflow via an axillary artery graft for the severely atheromatous aorta
Ann. Thorac. Surg., July 1, 1998; 66(1): 33 - 37.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
V. R. Machiraju, M. H. Culig, R. L. Heppner, R. A. Minella, and J. D. O'Toole
Value of Reversed Saphenous Vein in Minimally Invasive Direct Coronary Artery Bypass Graft Procedures
Ann. Thorac. Surg., March 1, 1998; 65(3): 625 - 627.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
DavidP. Bichell, J. M. Balaguer, S. F. Aranki, G. S. Couper, D. H. Adams, R. J. Rizzo, J. J. Collins Jr, and L. H. Cohn
Axilloaxillary Cardiopulmonary Bypass: A Practical Alternative to Femorofemoral Bypass
Ann. Thorac. Surg., September 1, 1997; 64(3): 702 - 705.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
D. D. Muehrcke, R. A. Grimm, S. E. Nissen, and D. M. Cosgrove III
Recurrent Cerebral Vascular Accidents Are an Indication for Ascending Aortic Endarterectomy
Ann. Thorac. Surg., May 1, 1996; 61(5): 1516 - 1518.
[Abstract] [Full Text]




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