Title
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
DOI
10.1097/IMI.0000000000000459