title: Bilateral axillary artery cannulation for severely calcified aorta and branches: a case report.
abstract: BACKGROUND
  Aortic valve surgery in patients with severely calcified aortas is technically challenging. Additionally, the choice of arterial cannulation site and whether to perform an aortic clamp to prevent neurological complications are poorly defined.
  
  
  METHODS
  We describe a patient with a severely calcified aorta and stenosis of its side branches. He successfully underwent aortic valve replacement with bilateral axillary artery cannulation and short-term moderate hypothermic circulatory arrest for cross-clamping of a severely calcified aorta to prevent neurological complications.
  
  
  CONCLUSIONS
  Bilateral axillary artery cannulation and short-term moderate hypothermic circulatory arrest for cross-clamping of the porcelain aorta is a suitable option to prevent neurological complications in patients with a severely calcified aorta and stenosis of its side branches who need aortic valve replacement.
authors.affiliation: Department of Cardiovascular Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Cardiovascular Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. tfukui.cvs@gmail.com.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001366:Axillary Artery / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002404:Catheterization / Q000379:methods; D050792:Circulatory Arrest, Deep Hypothermia Induced; D003250:Constriction; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology / Q000517:prevention & control
keywords: Aortic calcification; Aortic stenosis; Aortic valve replacement; Case report