title: Cannulation of the innominate artery during surgery of the thoracic aorta: our experience in 55 patients.
abstract: BACKGROUND
  Alternative cannulation sites such as the right/left axillary artery, the ascending aorta and aortic arch have been recently preferred to the femoral artery to improve neurologic outcome in patients undergoing surgery of the thoracic aorta. In 2004, we started to select the innominate artery as an arterial cannulation site for CPB and antegrade cerebral perfusion institution. Here we present our preliminary experience with 55 patients.
  
  
  METHODS
  Between November 2004 and 2006, 55 patients (mean age 60+/-14 years) underwent surgery on the thoracic aorta using the innominate artery as a site for arterial cannulation. Indication for surgery was a degenerative aneurysm in 49 (89.1%), an acute type A dissection in 2 patients (3.6%), a post-dissection aneurysm in 3 (5.4%), a supravalvular aortic stenosis in 1 patient (1.8%). Operative procedure included total arch replacement (n=9), hemiarch replacement (n=6), ascending aorta replacement (n=21), Bentall procedure (n=18) and aortoplasty with patch (n=1). Mean CPB and cross clamp times were 131+/-60 and 95+/-29 min, respectively. Mean cerebral perfusion time was 54+/-26 min.
  
  
  RESULTS
  The hospital mortality rate was 3.6%. There were no permanent neurologic dysfunction and one (1.8%) temporary neurological dysfunction.
  
  
  CONCLUSIONS
  Our results with the cannulation of the innominate artery were encouraging. This provides the same advantages of the axillary artery cannulation with greater simplicity and avoiding extra surgical incisions which may be site for local complications. It may represent a valid option for CPB and antegrade cerebral perfusion institution in aortic procedures.
authors.affiliation: Department of Cardiovascular Surgery, Santa Maria Hospital, Bari, Italy. m-dieus@hotmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Di Eusanio
authors.forename: Michele
authors.initials: M
authors.lastname: Ciano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Labriola
authors.forename: Giosuè
authors.initials: G
authors.lastname: Lionetti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Eusanio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D016122:Brachiocephalic Trunk / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods; D002404:Catheterization / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods; D011183:Postoperative Complications; D016896:Treatment Outcome