Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, İstanbul

Background: Axillary artery cannulation allows easy implantation of antegrade cerebral perfusion while reducing cannulation- related atheroembolic events or false lumen perfusion during cardiopulmonary bypass. For this reason, it has been preferred to femoral cannulation in recent years. This study aimed to evaluate the results of axillary artery cannulation in first 30 patients operated on for pathologies of the ascending aorta or the aortic arch. Methods: The study included 30 consecutive patients (20 males, 10 females; mean age 59 years; range 36 to 74 years) who underwent direct axillary cannulation using an open-end straight femoral cannula. Indications for surgery included aneurysm of the ascending aorta (n=14), acute type A aortic dissection (n=12), aneurysm of the aortic arch (n=2), aortic intramural hematoma (n=1), and aneurysms of the ascending aorta, aortic arch, and descending aorta (n=1). Results: Axillary artery cannulation was successful in all the patients. Permanent brachial plexus injury did not occur. Axillary artery dissection occurred in only one patient (3.3%). Malperfusion was not observed during cardiopulmonary bypass. Twenty-five patients required hypothermic circulatory arrest with a mean duration of 36±19 minutes. Inhospital mortality was seen in three patients (10%). Permanent stroke occurred in two patients (6.7%) and transient neurologic dysfunction occurred in two patients. Conclusion: Axillary artery cannulation is easy and safe. It decreases the rate of transient neurologic dysfunction by allowing easy implantation of the antegrade cerebral perfusion and decreases possibility of malperfusion during repair of the dissection, and is associated with very rare local wound problems. Therefore, it should be preferred in cases in which the ascending aorta is not suitable for cannulation.