Thorac Cardiovasc Surg 2013; 61(07): 584-586
DOI: 10.1055/s-0032-1333135
How to Do It
Georg Thieme Verlag KG Stuttgart · New York

Bilateral Cerebral Perfusion via Right Axillary Artery Cannulation Alone in Aortic Arch Surgery

Carlo Bassano
1   Operative Unit of Cardiac Surgery, Tor Vergata University, Rome, Italy
,
Charles Mve Mvondo
1   Operative Unit of Cardiac Surgery, Tor Vergata University, Rome, Italy
,
Emanuele Bovio
1   Operative Unit of Cardiac Surgery, Tor Vergata University, Rome, Italy
,
Luigi Chiariello
1   Operative Unit of Cardiac Surgery, Tor Vergata University, Rome, Italy
› Author Affiliations
Further Information

Publication History

10 July 2012

20 November 2012

Publication Date:
23 January 2013 (online)

Abstract

Several methods have been proposed to avoid cerebral damage during aortic arch surgery. Antegrade, bilateral, selective cerebral perfusion is probably the most efficient one, although it has some drawbacks, such as air or particulate embolism risk, limitation in operative field visibility, and interactions with surgical maneuvers. We describe a surgical technique that provides bilateral antegrade perfusion to the brain, via the right axillary artery, with no need of additional arterial lines or shunting devices.

 
  • References

  • 1 Griepp RB, Stinson EB, Hollingsworth JF, Buehler D. Prosthetic replacement of the aortic arch. J Thorac Cardiovasc Surg 1975; 70 (6) 1051-1063
  • 2 Ueda Y, Miki S, Kusuhara K, Okita Y, Tahata T, Yamanaka K. Surgical treatment of aneurysm or dissection involving the ascending aorta and aortic arch, utilizing circulatory arrest and retrograde cerebral perfusion. J Cardiovasc Surg (Torino) 1990; 31 (5) 553-558
  • 3 Kazui T, Inoue N, Yamada O, Komatsu S. Selective cerebral perfusion during operation for aneurysms of the aortic arch: a reassessment. Ann Thorac Surg 1992; 53 (1) 109-114
  • 4 Sabik JF, Lytle BW, McCarthy PM, Cosgrove DM. Axillary artery: an alternative site of arterial cannulation for patients with extensive aortic and peripheral vascular disease. J Thorac Cardiovasc Surg 1995; 109 (5) 885-890 , discussion 890–891
  • 5 Ye J, Dai G, Ryner LN , et al. 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 1999; 100 (19, Suppl) II309-II315
  • 6 Merkkola P, Tulla H, Ronkainen A , et al. Incomplete circle of Willis and right axillary artery perfusion. Ann Thorac Surg 2006; 82 (1) 74-79