ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Cannulation of the right axillary artery is a safe method in proximal aortic surgery
Gökhan Önem1, Ahmet Baltalarlı1, Ercan Gürses2, Ali Vefa Özcan1, Mustafa Saçar1, Fahri Adalı1, Hülya Sungurtekin2
1Pamukkale Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Denizli
2Pamukkale Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, Denizli
Background: Currently, the standard peripheral arterial cannulation site is the common femoral artery in cardiopulmonary bypass. However, the axillary artery can be used when the ascending aorta is not suitable for cannulation in proximal aortic surgery. We evaluated patients in whom cannulation was performed through the axillary artery.

Methods: The study included 14 patients (6 women, 8 men; mean age 60 years; range 41 to 77 years) who underwent right axillary artery cannulation. Indications were ascending aortic aneurysm (n=8), type A aortic dissection (n=5), and aortic stenosis (n=1). Four patients had a previous cardiac surgery. The most frequent surgical procedures were supracoronary ascending thoracic aorta (ATA) replacement in seven patients, and aortic valve replacement and ATA replacement in two patients. The axillary artery was cannulated directly in one patient and with a prosthetic Dacron graft in the other patients. Antegrade cerebral perfusion via the axillary artery was used under hypothermic circulatory arrest in 13 patients.

Results: Postoperative mortality occurred in three patients (21.4%). Two patients died from multiorgan failure, and one patient died from bleeding. Arterial flow in the axillary artery was sufficient in all patients. There were no cannulation-related complications including mortality, stroke, brachial plexus injury, axillary artery thrombosis, or infection.

Conclusion: Axillary artery cannulation for cardiopulmonary bypass seems to be an easy, safe, and effective procedure in a variety of cardiac surgical procedures such as aortic dissections, ascending aortic aneurysms, calcified aorta, and reoperations.

Keywords : Aneurysm, dissecting/surgery; aortic aneurysm, thoracic/ surgery; axillary artery; cardiopulmonary bypass/methods; catheterization, peripheral/methods
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