title: Axillary Artery Cannulation in Acute Aortic Dissection: A Word of Caution.
abstract: Arterial cannulation into the right axillary artery is a commonly adopted perfusion strategy in the treatment of acute aortic dissection. Here we describe our experience of accidentally cannulating the axillary artery in a case of acute aortic dissection with an aberrant right subclavian artery, which was missed preoperatively because its proximal segment was malperfused by the dissection and thereby not enhanced. The rapid hemodynamics collapse at the start of the bypass was reversed by prompt switching to femoral perfusion. Postoperative follow-up computed tomographic angiography revealed a well-perfused right aberrant subclavian artery. Surgeons should be aware of an aortic arch anomaly whenever performing an axillary artery cannulation.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University, Incheon, South Korea. Electronic address: wkbaek@inha.ac.kr.
authors.forename: Wan Ki
authors.initials: WK
authors.lastname: Baek
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University, Incheon, South Korea.
authors.forename: Young Sam
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University, Incheon, South Korea.
authors.forename: Mina
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University, Incheon, South Korea.
authors.forename: Yong Han
authors.initials: YH
authors.lastname: Yoon
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University, Incheon, South Korea.
authors.forename: Joung Taek
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology, College of Medicine, Inha University, Incheon, South Korea.
authors.forename: Hyun Kyung
authors.initials: HK
authors.lastname: Lim
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001366:Axillary Artery; D002315:Cardiopulmonary Bypass / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome