title: Simple and controlled method to avoid hyperperfusion of the right arm following axillary artery cannulation for extracorporeal membrane oxygenator support.
abstract: The right axillary artery has become the cannulation site of choice for establishment of extracorporeal membrane oxygenator support in many centers. Dissection and cannulation of this vessel are simple and safe in the majority of patients. Typically, a side graft is used to avoid malperfusion of the right arm. Although this protocol offers many advantages, a common complication is the critical hyperperfusion of the right arm. Subsequent compartment syndrome and decline of antegrade inflow of oxygenated blood, especially into the brain and coronary arteries, can be life threatening in such critical patients. We describe herein a simple yet effective and controlled technique to avoid this particular problem.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang-Goethe University, Frankfurt am Main, Germany.
authors.forename: Nestoras
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: Ali El-Sayed
authors.initials: Ael-S
authors.lastname: Ahmad
authors.forename: Spiros
authors.initials: S
authors.lastname: Marinos
authors.forename: Anton
authors.initials: A
authors.lastname: Moritz
authors.forename: Andreas
authors.initials: A
authors.lastname: Zierer
mesh_terms: D001366:Axillary Artery / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D005268:Femoral Vein; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D012039:Regional Blood Flow; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*