title: Use of axillary cannulation for simultaneous endo-occlusion and antegrade perfusion during minimally invasive surgery.
abstract: OBJECTIVE
  We aimed to develop an antegrade arterial perfusion method that would allow a single suture line on the heart.
  
  
  METHODS
  Using an 8-mm Dacron graft sewn to the right axillary artery, we performed antegrade arterial flow and simultaneous endo-occlusion, as well as the delivery of antegrade cardioplegia.
  
  
  RESULTS
  Five patients underwent right axillary antegrade flow, with intention to use axillary endo-occlusion. There were no deaths, axillary artery injuries, or conversions to sternotomy. One patient who had a small (6 mm) axillary artery required femoral arterial balloon placement with axillary arterial flow. When using a 100-mm endoballoon, transesophageal echo alone is suitable for placement of the endoballoon. All patients are alive and doing well at least 1 year after surgery.
  
  
  CONCLUSIONS
  The right axillary artery is a suitable conduit for simultaneous endo-occlusion, antegrade flow, and antegrade cardioplegia delivery during mitral valve surgery.
authors.affiliation: Department of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Carver College of Medicine, Iowa City, IA 52242, USA. robert-farivar@uiowa.edu
authors.forename: Robert Saeid
authors.initials: RS
authors.lastname: Farivar
authors.forename: Joss D
authors.initials: JD
authors.lastname: Fernandez
mesh_terms: D000368:Aged; D001366:Axillary Artery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D002404:Catheterization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000379:methods*; D006331:Heart Diseases / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010477:Perfusion / Q000379:methods*
chemical_list: D002314:Cardioplegic Solutions