Left Axillary Artery Cannulation Facilitates Reoperative Total Aortic Arch Replacement

Publication Date

2018

Journal Title

Innovations

Abstract

Total aortic arch replacement remains a technically formidable procedure, particularly in patients with previous proximal aortic dissection repair. Our case discussion highlights a useful strategy for extracorporeal support and circulation management to facilitate total arch reconstruction in the reoperative setting, based on cannulation of the left axillary artery. Our preference is to use a left axillary artery approach to initiate cardiopulmonary bypass and to ultimately revascularize the left arm via an extra-anatomic graft. Our technique, as described, affords the option to initiate cardiopulmonary bypass before sternal re-entry, it reduces the risk of embolic complications and possible stroke, and it directly facilitates simple extra-anatomic debranching of the left subclavian artery, resulting in easier arch and great vessel reconstruction within the chest.

Volume Number

13

Issue Number

1

Pages

70 - 73

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Cardiovascular and Thoracic Surgery

PMID

29432362

DOI

10.1097/IMI.0000000000000459

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