Axillary artery in cardiopulmonary bypass: indications and results.
OBJECTIVE
To determine indications and results of axillary artery cannulation for cardiopulmonary bypass.


METHODS
From January 2005 through December 2008, axillary artery cannulation was used in 48 patients. Mean age was 62 +/- 11 years and 33 (69%) patients were males. Axillary artery was approached by infraclavicular incision and the cannula introduced in a 8 millimeter Dacron side graft.


RESULTS
Indications were calcified aorta (N=18, 38%), aortic dissection (N=15, 31%), ascending and/or aortic arch aneurysm (N=11, 23%) and prior to reoperative median sternotomy (N=4, 8%). Changes in intraoperative planning occurred most often in patients with calcified aorta (100% versus 10%, P<0.0001) than in patients with other indications, which follow their preoperative plan. Cardiopulmonary bypass (deep hypothermic circulatory arrest in 55% and conventional in the remaining) was uneventfully conducted in all patients but one (success rate 98%) due to undiagnosed inominate artery stenosis. Local complication was lymphatic drainage in three (6.2%) patients.


CONCLUSIONS
Axillary artery is an alternative cannulation site in patients unsuitable to aortic cannulation. The type of indication may determine intraoperative changes in surgical planning.
Atik
Fernando A
FA
Instituto de Cardiologia do Distrito Federal, Fundação Universitária de Cardiologia, Brasília, DF, Brazil. atikf@mac.com
Faber
Cristiano N
CN
Corso
Ricardo B
RB
Santos
Mateus de Souza
Mde S
Michelette
Karina Pereira
KP
Barros
Maria Regina
MR
Caneo
Luiz Fernando
LF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000145:classification / Q000601:surgery*; D001366:Axillary Artery; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D002404:Catheterization / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome