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J Thorac Cardiovasc Surg 2003;126:2106-2107
© 2003 The American Association for Thoracic Surgery

Letter to the editor

Brachial artery cannulation

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Sihhiye, Ankara, 06100, Turkey

To the Editor:

In their report Galajda and colleagues¹ describe their technique of brachial artery cannulation for two patients with type A aortic dissection. One patient was cannulated through left brachial artery, and the authors mentioned that they performed the operation without circulatory arrest. Preferring the left brachial artery instead of right for cannulation site may limit the use of open distal repair technique when necessary. Our group has reported 104 cases of arch repair using right brachial artery where open distal repair was easily performed by reducing the flow and applying atraumatic vascular clamps to the innominate and left carotid arteries.²

The authors have reported using 20F cannulas during their two operations. According to our experience, a 20F cannula is too large for the great majority of patients. We preferred using the Calmed non–wire reinforced venous return catheter (California Medical Laboratories, Irvine, Calif), the tip of which can be trimmed to 16F to 18F diameter according to the size of the patients’ brachial artery due to its conical shape.

The authors suggest that the end of the inserted cannula should not extend beyond the origin of the subscapular artery to protect collateral circulation of the upper limb. We inserted the catheter into the brachial artery as its tip is positioned 5 to 7 cm proximal to the arteriotomy, which in most cases extended beyond the origin of the subscapular artery, but this did not cause upper limb ischemia in any of our patients.

We are in complete agreement with the authors that the brachial artery is an easily accessible site for cannulation. In our current practice it is the standard for the repair of aneurysms and dissections of the aortic arch.

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1. Galajda Z, Szentkirdyi I, Peterffy A. Brachial artery cannulation in type A aortic dissection operations. J Thorac Cardiovasc Surg. 2003;125:407–409[Free Full Text]
   
2. Tasdemir O, Saritas A, Kucuker S, Ozatik MA, Sener E. Aortic arch repair with right brachial artery perfusion. Ann Thorac Surg. 2002;73:1837–1842[Abstract/Free Full Text]
   

This Article Full Text (PDF) 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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Seref A. Kucuker Oguz Tasdemir Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kucuker, S. A. Articles by Tasdemir, O. Search for Related Content PubMed PubMed Citation Articles by Kucuker, S. A. Articles by Tasdemir, O. Related Collections Great vessels Related Article