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Indian Journal of Extra-Corporeal Technology
Year : 2018, Volume : 27, Issue : 1
First page : ( 10) Last page : ( 15)
Print ISSN : 2231-0665. Online ISSN : 2231-0673.

Cannulation of the right axillary artery for acute type-A aortic dissection surgery: Indirect versus direct cannulation with the optisite arterial cannula.

Carozza Roberto, Pietrini Armando, Scarano Daniela, Fazzi Diego, Aratari Carlo, Rescigno Giuseppe

Unit of Cardiopulmonary Perfusion & Division of Cardiac Surgery, Ospedali Riuniti, Ancona, Italy

Online published on 17 October, 2018.

Abstract

Background

Cannulation of right axillary artery is a common technique for delivering cardiopulmonary bypass inflow in acute type A aortic dissection surgery, which offers some advantages over the traditional femoral artery cannulation. Cannulation of right axillary artery is usually indirect, through a vascular graft anastomosed to the artery, but also direct, with an arterial cannula. We reviewed our experience with these two types of cannulation.

Methods

From the 31 August 2012 to the 31 August 2016, 76 patients were operated upon for acute type A aortic dissection, 61 patients had an indirect right axillary artery cannulation and 15 a direct cannulation using the Optisite arterial cannula. Patients were followed up for three months.

Results

Although there was an element in hypo perfusion in the direct cannulation group, it was significant only in the period of normothermia at the beginning of cardiopulmonary bypass, with no apparent consequences for the patients. The were no other differences between the two groups in terms of preoperative, operative and outcome data

Conclusion

Considering that direct cannulation is simpler and faster than indirect cannulation, if technically possible, we recommend it in this kind of surgery, whenever RAA cannulation is the choice.

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Keywords

Right axillary artery cannulation, aortic dissection, Optisite arterial cannula, hypothermic CPB arrest, antegrade cerebral perfusion.

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