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Taijiro Sueda
Kenji Okada
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J Thorac Cardiovasc Surg 2009;138:251-252
© 2009 The American Association for Thoracic Surgery

Letter to the Editor

Reply to the Editor

Kazumasa Orihashi, MD, Taijiro Sueda, MD, Kenji Okada, MD, Shinya Takahashi, MD

Hiroshima University Hospital, Hiroshima, Japan

The first 20% of the full text of this article appears below.

We thank Rescigno and colleagues for their insightful comments regarding the pitfalls of axillary arterial perfusion. The case they presented illustrates another important mechanism of cerebral malperfusion under axillary perfusion. The surgical intervention can form a blind pocket (cul-de-sac) under retrograde perfusion, dilate the false lumen, and occlude the orifice of the right common carotid artery. We believe that the mechanism they postulated is right.

The "Y-junction" consisting of the innominate, right common carotid, and right subclavian (axillary) arteries is a tricky zone in aortic surgery, where cerebral malperfusion can be induced by various mechanisms: compression of the true lumen in the innominate artery in our case; blind pocked-induced . . . [Full Text of this Article]


Related Article

Axillary artery cannulation pitfalls
Giuseppe Rescigno, Carlo Aratari, and Marco L.S. Matteucci
J. Thorac. Cardiovasc. Surg. 2009 138: 251. [Extract] [Full Text] [PDF]





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