Left axillary artery perfusion in surgery of type A aortic dissection.
OBJECTIVE
A left axillary artery perfusion instead of a femoral perfusion has the benefit of avoiding false lumen perfusion and atheroembolization into the brain, which is caused by retrograde perfusion in type A aortic dissection surgery. We performed type A aortic dissection surgery using the left axillary artery perfusion technique and reviewed this method.


METHODS
From April 2002 to January 2004, 8 patients with a mean age of 70 years (48 to 81), underwent axillary artery cannulation with a side graft technique in type A aortic dissection operations. Six patients had acute type A and 2 had chronic type A dissections. The surgical procedures were ascending aortic replacement in 5, hemiarch replacement in 2, and total arch replacement in 1.


RESULTS
In all patients, a cardiopulmonary bypass was established through the left axillary perfusion. There were no operative deaths and no hospital deaths. All patients were able to avoid cerebral vascular accidents. One patient required a femoro-femoro bypass on the 10th postoperative day because of malperfusion of the left leg, which occurred suddenly. Postoperative hemorrhaging requiring resternotomy occurred in 2 patients.


CONCLUSIONS
A left axillary artery perfusion is safe and useful for arterial inflow for type A aortic dissection surgery.
Kano
Masashi
M
Department of Cardiovascular Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan.
Chikugo
Fumio
F
Shimahara
Yusuke
Y
Urata
Masahisa
M
Hayamizu
Tomohiko
T
D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001366:Axillary Artery; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome