ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Axillary artery cannulation in ascending aortic pathologies
Altuğ Tuncer1, Eylem Yayla Tuncer1, Adil Polat2, İlker Mataracı3, Cüneyt Keleş1, Salih Aulasaleh1, Kamil Boyacıoğlu1, İbrahim Kara4, Kaan Kırali1
1Department of Cardiovascular Surgery, Kartal Koşuyolu Heart Education and Research Hospital, İstanbul
2Department of Cardiovascular Surgery, Bağcılar Training and Research Hospital, İstanbul
3Department of Cardiovascular Surgery, Trabzon Ahi Evren Training and Research Hospital, Trabzon
4Department of Cardiovascular Surgery, Göztepe Şafak Hospital, İstanbul
DOI : 10.5606/tgkdc.dergisi.2011.084
Background: We analyzed the results of axillary cannulation for cardiopulmonary bypass (CPB) and the factors affecting mortality and morbidity.

Methods: Eighty-four patients (58 males, 26 females; mean age 53.8±13.2 years; range 20 to 77 years) were operated on for ascending aortic pathologies with axillary arterial cannulation between November 2006 and January 2009. Overall, 124 procedures were performed in 84 patients, and the most commonly performed procedure was the replacement of the ascending aorta which was employed in 64 patients (76.2%). The most common indication for operation was ascending aortic aneurysm that was present in 51 patients (60.7%). Three (3.6%) patients had previously undergone open heart surgery. Hypothermic circulatory arrest was used in 51 (60.7%) patients, and the axillary artery was cannulated directly in 75 (89.3%) patients and via a side graft in nine (10.7%) patients.

Results: Postoperatively, three patients (3.6%) had in-hospital mortality because of sepsis, intraoperative bleeding, and low cardiac output syndrome. Neurological complications were seen in 10 (11.9%) patients (8 had transient neurological dysfunction and 2 had stroke). The mean duration of hospital stay was 5.1±5.6 (range 1 to 46) days. Postoperative follow-up was 10.3±5.5 (range 1 to 15.5) months on average (total of 68.5 patient/years). There was no mortality during the follow-up after discharge. No relationship was found between the method of cannulation and mortality or, neurological complications.

Conclusion: The axillary artery is a safe route for arterial cannulation, and the axillary route does not cause an increase in postoperative mortality and morbidity.

Keywords : Ascending aorta; axillary artery cannulation; selective antegrade cerebroplegia
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