Left Axillary Artery Cannulation Facilitates Reoperative Total Aortic Arch Replacement

2018 ◽  
Vol 13 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Jonathan M. Hemli ◽  
Bo Gu ◽  
S. Jacob Scheinerman ◽  
Derek R. Brinster
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Axillary Artery ◽  
Aortic Arch Replacement ◽  
Artery Cannulation ◽  
Total Aortic Arch Replacement ◽  
Vessel Reconstruction ◽  
Arch Reconstruction ◽  
Left Axillary Artery ◽  
Extracorporeal Support

Total aortic arch replacement remains a technically formidable procedure, particularly in patients with previous proximal aortic dissection repair. Our case discussion highlights a useful strategy for extracorporeal support and circulation management to facilitate total arch reconstruction in the reoperative setting, based on cannulation of the left axillary artery. Our preference is to use a left axillary artery approach to initiate cardiopulmonary bypass and to ultimately revascularize the left arm via an extra-anatomic graft. Our technique, as described, affords the option to initiate cardiopulmonary bypass before sternal re-entry, it reduces the risk of embolic complications and possible stroke, and it directly facilitates simple extra-anatomic debranching of the left subclavian artery, resulting in easier arch and great vessel reconstruction within the chest.

Axillary artery cannulation: routine use in ascending aorta and aortic arch replacement

2004 ◽  
Vol 78 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Justus T Strauch ◽  
David Spielvogel ◽  
Alexander Lauten ◽  
Steven L Lansman ◽  
Kirk McMurtry ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Axillary Artery ◽  
Ascending Aorta ◽  
Aortic Arch Replacement ◽  
Artery Cannulation

scholarly journals The strategy of cardiopulmonary bypass for total aortic arch replacement and the frozen elephant trunk technique with aortic balloon occlusion

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052090541
Author(s):  
Yunfeng Li ◽  
Shujie Yan ◽  
Song Lou ◽  
Xiaogang Sun
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Balloon Occlusion ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement ◽  
Aortic Balloon Occlusion ◽  
Occlusion Technique ◽  
Balloon Occlusion Technique

Objective To investigate the use of the aortic balloon occlusion technique to assist total aortic arch replacement (TAR) with frozen elephant trunk (FET) to shorten the lower body circulatory arrest (CA) time and raise the nadir temperature during cardiopulmonary bypass. Methods This retrospective study reviewed consecutive patients that underwent aortic balloon occlusion to assist TAR with FET and patients that received conventional TAR with FET procedures. Preoperative characteristics, perioperative characteristics and postoperative outcomes were compared between the two groups. Results The study included130 patients treated with aortic balloon occlusion and 230 patients treated with conventional TAR with FET. The 30-day mortality rate was similar between the aortic balloon occlusion and conventional groups (4.62% versus 7.83%, respectively). Multivariate analysis showed that aortic balloon occlusion reduced the incidence of acute kidney injury, hepatic injury and red blood cell transfusion. The application of aortic balloon occlusion reduced the mean ± SD CA time from 17.24 ± 4.36 min to 6.33 ± 5.74 min, with the target nadir nasal temperature being increased from 25°C to 28°C. Conclusion The aortic balloon occlusion technique achieved significant improvements in reducing complications, but this did not translate into lower 30-day mortality.

Innominate Artery Cannulation for Aortic Surgery

2007 ◽  
Vol 15 (4) ◽  
pp. 348-350 ◽  
Author(s):  
Kuan-Ming Chiu ◽  
Shao-Jung Li ◽  
Tzu-Yu Lin ◽  
Chih-Yang Chan ◽  
Shu-Hsun Chu
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Axillary Artery ◽  
Aortic Surgery ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Effective Alternative ◽  
Artery Cannulation ◽  
Aortic Cannulation

When disease involving the ascending aorta or aortic arch precludes ascending aortic cannulation, axillary artery cannulation is used for cardiopulmonary bypass. An additional incision and the relatively small caliber of the axillary artery are the drawbacks of this approach. Innominate artery cannulation using the same sternotomy wound is a simple and effective alternative.

scholarly journals Modified Isolated Cerebral Perfusion Technique for Prevention of Stroke With Aortic Arch Replacement

2021 ◽  
Author(s):  
Yasumi Maze ◽  
Toshiya Tokui ◽  
Masahiko Murakami ◽  
Teruhisa Kawaguchi ◽  
Ryosai Inoue ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Cerebral Perfusion ◽  
Left Subclavian Artery ◽  
Axillary Artery ◽  
Selective Cerebral Perfusion ◽  
Aortic Arch Replacement ◽  
Artery Cannulation ◽  
Postoperative Stroke ◽  
Artificial Graft

Abstract In aortic arch replacement, an isolated cerebral perfusion method has been reported in additional to axillary artery cannulation to prevent postoperative stroke. We have made changes to this method. In other words, we devised a method to reduce cerebral embolism by performing selective cerebral perfusion via an artificial graft anastomosed to the left common carotid artery and the left subclavian artery. This method was performed in 7 cases, and all patients were discharged alive without any neurological disorders. In the surgical procedure of the aortic arch, sufficient care must be taken in the manipulation around the brachiocephalic artery and the left subclavian artery. Our method can avoid reinsertion due to desorption of the cerebral perfusion cannula and can be expected to prevent postoperative stroke.

Total Aortic Arch Replacement: An Evolving Process

2020 ◽  
Vol 32 (4) ◽  
pp. 696-697
Author(s):  
Vishal N. Shah ◽  
Serge Sicouri ◽  
Konstadinos A. Plestis
Keyword(s):  
Aortic Arch ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement

Total Aortic Arch Replacement and Frozen Elephant Trunk

2020 ◽  
Author(s):  
Jacky Y.K. Ho ◽  
Simon C.Y. Chow ◽  
Micky W.T. Kwok ◽  
Takuya Fujikawa ◽  
Randolph H.L. Wong
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement
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