[Axillary artery cannulation for extracorporeal circulation].
BACKGROUND
When the ascending aorta and the femoral artery cannot be used for extracorporeal circulation, an emerging alternative is the use of axillary artery.


OBJECTIVE
To report the experience using the axillary artery for extracorporeal circulation.


METHODS
Between November 1998 and May 2002, 22 patients (14 male) were operated with extracorporeal circulation, cannulating the axillary artery. Briefly, an incision is made below the middle third of the clavicle and a cut is made on major pectoris muscle. Minor pectoris muscle is retracted and axillary artery is exposed. It is cannulated directly or with the aid of a prosthesis.


RESULTS
Right axillary artery was used in 21 patients and in 20 it was cannulated with the aid of a prosthesis. Mean flow was 4.5 +/- 0.6 l/min. The most common indications were aortic dissection or aneurysms. The most common procedures done, were ascending aorta replacement in 8 cases and replacement of ascending aorta and aortic arch in 5. Thirty five percent of operations were emergencies and 32% were reoperations. In 15 patients (68%), a circulatory arrest was done. Of these, retrograde brain perfusion was used in 9, antegrade brain perfusion through the same axillary artery was used in 2 and mixed perfusion was used in 2. One patient had a complication related to the axillary cannulation. None had cerebrovascular accidents or thromboembolic complications. Two patients died in the postoperative period. Patients were followed up to 42 months after the procedure and no secondary complications of the cannulation were detected.


CONCLUSIONS
When the ascending aorta and the femoral artery cannot be used, axillary artery is a good alternative for extracorporeal circulation.
Zalaquett
Ricardo
R
Departamento de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile. rzalaque@med.puc.cl
Bahamondes
Juan C
JC
Mertens
Renato
R
Morán
Sergio
S
Irarrázaval
Manuel J
MJ
Becker
Pedro
P
Maturana
Gustavo
G
Arretz
Claudio
C
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery; D001366:Axillary Artery; D002406:Catheterization, Peripheral / Q000379:methods*; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged