Axillary artery perfusion in acute type A aortic dissection repair.
BACKGROUND
We evaluated our experience with axillary artery perfusion technique in acute type A aortic dissection repair.


METHODS
Between September 2000 and July 2006, 41 consecutive patients with acute type A aortic dissection underwent surgical repair. In 35 of 41 patients (85.4%), arterial perfusion was performed through right axillary artery and in the remaining six patients (14.6%), arterial perfusion site was femoral artery. Indication for femoral artery perfusion was cardiac arrest and ongoing cardiopulmonary resuscitation in one and pulselessness of right upper limb in five patients. Mean age was 54.9 +/- 15.3 (16 to 90 years) and 28 were male. Unilateral antegrade cerebral perfusion (perfusate temperature 22 to 25 degrees C) through axillary artery was performed in all axillary artery perfused patients and in three patients who had femoral artery perfusion.


RESULTS
Five patients died postoperatively (hospital mortality 12.2%). All of them had evidence of single or multiple organ malperfusion preoperatively. We did not experience any new transient or permanent neurologic deficit after the procedure in the unilateral antegrade cerebral perfusion patients. Complications related to axillary artery cannulation were observed in two patients (5.3%). One patient with femoral artery cannulation experienced femoral arterial thrombosis, postoperatively.


CONCLUSIONS
Right axillary artery cannulation for repair of acute type A aortic dissection is a simple and safe procedure. In the case of pulselessness of right upper limb, femoral artery is still the choice of cannulation site.
Battaloglu
Bektas
B
Department of Cardiovascular Surgery, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey. bbattaloglu@inonu.edu.tr
Erdil
Nevzat
N
Nisanoglu
Vedat
V
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D016887:Cardiopulmonary Resuscitation; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006323:Heart Arrest; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult