Objective Axillary artery cannulation is still regarded with distrust by surgeons because the artery is supposed to be fragile, difficult to access, and its cannulation is often considered time-consuming. This study was carried out to assess our results in a series of patients, using a simplified surgical approach to axillary artery cannulation. Methods Data were collected retrospectively from our prospective database. All patients operated on in our department between January 2004 and October 2016 and scheduled for various cardiac procedures with direct axillary artery cannulation were included in this study. In this twelve-year period, 246 patients had direct axillary artery cannulation during a cardiac surgical procedure. The mean age was 67.3 ± 14.7 years. The artery was approached at the level of the deltopectoral groove and cannulated by the direct Seldinger technique. Results The main indications for axillary artery cannulation were: right minithoracotomy aortic valve replacement ( n = 93), aortic dissection ( n = 57), extracorporeal life support ( n = 36), transarterial valve replacement ( n = 27), ascending aortic aneurysm ( n = 16), and others ( n = 17). The cannulation was right-sided in 90.6% of patients. Axillary cannulation-related morbidity was 6.1%. Axillary cannulation-related mortality was 0.8% (2 patients). Conclusions The axillary artery is a reliable site for rapid cannulation, carrying a low risk of morbidity and mortality. Our findings show that this artery is solid and can be very useful in everyday cardiac surgical practice.
Extracorporeal membrane oxygenation can be done through several cannulation sites. Axillary artery cannulation is commonly performed through a Dacron graft sutured in an end-to-side fashion to the axillary artery. Direct cannulation of the axillary artery appears a reliable technique with low rate of complications. We report our experience in 16 patients using the direct cannulation technique.
Elective cardiac surgery in severely obese patients was not associated with increased perioperative morbimortality, but had a higher superficial wound infection risk. Nevertheless, severe obesity itself should not be a contraindication to elective surgery.
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