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J Thorac Cardiovasc Surg 1995;110:1775
© 1995 Mosby, Inc.

LETTERS TO THE EDITOR

Axillary artery for extracorporeal circulation

Division of Thoracic and Cardiovascular Surgery
Hannover Medical School
Hannover, Germany

To the Editor:

I read with great interest the contribution of Sabik and coworkers on the use of the axillary artery as an access for extracorporeal circulation (J THORAC CARDIOVASC SURG1995;109:885-91). Their report focused primarily on the prevention of stroke and organ injury, for which axillary artery perfusion was documented to be superior to other routes in selected patients. I would like to report another variant of this access. In 1984, a 44-year-old female patient came to the attention of my group because of severe aortic insufficiency and root ectasia with an excessively calcified ascending aorta and arch. In addition, she had occlusion of the infrarenal aorta associated with severe leg ischemia. As a result, neither the proximal aorta nor the femoral arteries were available for cannulation. I therefore decided to place an extraanatomic bypass from the left axillary artery to the left common femoral artery to which a side arm was connected, with the sidearm serving for arterial cannulation. A valved composite graft was then inserted, with the distal anastomosis sutured with heavily pledget-supported, interrupted mattress sutures placed with sharp needles. The patient had an uneventful postoperative course, and an infrarenal Y-graft was subsequently inserted. At that time, the extraanatomic bypass was removed. This patient recently required replacement of the originally inserted aortic xenograft but otherwise is doing well.

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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hans G. Borst Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Borst, H. G. Search for Related Content PubMed Articles by Borst, H. G.