Axillary artery cannulation in acute ascending aortic dissections.
BACKGROUND
Standard cannulation of the femoral artery in preparation for repair of a dissection involving the ascending aorta carries a high risk of malperfusion. Arterial perfusion through the right axillary artery is more likely to perfuse the true lumen and should be advantageous in acute dissections involving the ascending aorta.


METHODS
Thirteen patients underwent repair of acute ascending aortic dissections and were perfused through the right axillary artery. All had deep hypothermic circulatory arrest.


RESULTS
There was one mild intraoperative cerebrovascular accident with complete recovery and one operative death secondary to low cardiac output. There were no intraoperative problems with perfusion through the axillary artery, and there were no postoperative problems or complications involving the axillary artery, axillary vein, or brachial plexus.


CONCLUSIONS
Arterial perfusion through the right axillary artery is a safe and effective means of more reliably perfusing the true lumen. In this regard, it may be superior to femoral artery perfusion and could lead to improved outcomes with repair of acute deBakey type I and II aortic dissections.
Whitlark
J D
JD
Main Line Cardiothoracic Surgeons, Lankenau Hospital, Jefferson Health System, Wynnewood, Pennsylvania 19096, USA. mlcts2220@aol.com
Goldman
S M
SM
Sutter
F P
FP
D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001366:Axillary Artery / Q000637:transplantation*; D002404:Catheterization / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures