Innominate artery cannulation for arterial perfusion during aortic arch surgery

Uchino, Gaku; Yunoki, Keiji; Sakoda, Naoya; Saiki, Masaaki; Hisamochi, Kunikazu; Yoshida, Hideo

doi:10.1111/jocs.13091

Cited by 16 publications

(19 citation statements)

References 21 publications

(58 reference statements)

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“…Other groups have proposed that direct aortic cannulation can be safe . Other potential sites of cannulation include the left ventricular apex, innominate artery, and carotid artery. However, the utilization of these approaches was unable to be determined in this study.…”

Section: Discussionmentioning

confidence: 99%

Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database

et al. 2018

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Purpose: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. Results: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension. The most common arterial cannulation strategies included femoral (36%), axillary (27%), and direct aortic (19%). The median perfusion and cross-clamp times were 181 and 102 min, respectively. The lowest temperature on bypass showed significant variation. Hypothermic circulatory arrest (HCA) was used in 78% of cases.Among those undergoing HCA, brain protection strategies included antegrade cerebral perfusion (31%), retrograde cerebral perfusion (25%), both (4%), and none (40%). Median HCA plus cerebral perfusion time was 40 min. Major complications included prolonged ventilation (53%), reoperation (19%), renal failure (18%), permanent stroke (11%), and paralysis (3%). Operative mortality was 17%. The median intensive care unit and hospital length of stays were 4.7 and 9.0 days, respectively. Among 640 centers, the median number of cases performed during the study period was three. Resuscitation, unresponsive state, cardiogenic shock, inotrope use, age >70, diabetes, and female sex were found to be independent predictors of mortality. Conclusions:These data describe contemporary patient characteristics, operative strategies, and outcomes for AAAD in North America. Mortality and morbidity for AAAD remain high.

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Section: Discussionmentioning

confidence: 99%

Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database

et al. 2018

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“…If the aortic graft or a pseudoaneurysm cavity appears adherent to the sternum, it may be prudent to place the patient on cardiopulmonary bypass using the axillary artery or the femoral artery as inflow and a venous cannula via the femoral vein and cooling the patient to near isoelectric electroencephalogram (EEG). If safe sternal reentry can be performed, the innominate artery is also a potential alternative site that can be used for arterial cannulation of infected ascending aortic grafts . Once sternal reentry is safely accomplished, the heart and aortopulmonary window are carefully dissected.…”

Section: Managementmentioning

confidence: 99%

Management of thoracic aortic graft infections

et al. 2018

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“…The subclavian access, which was used in this patient, can now be accessed using percutaneous techniques for the axillary artery . The innominate artery is another potential site but requires a partial sternotomy . In addition, the transcarotid approach can also be used and allows safe and rapid exchange for bailout procedures should they be necessary …”

Section: Discussionmentioning

confidence: 99%

Balloon aortic valvuloplasty via a bilateral trans-radial artery approach prior to transcatheter aortic valve replacement

2018

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Balloon aortic valvuloplasty (BAV) intervention is used as destination therapy or as a bridge to percutaneous or surgical aortic valve intervention. BAV is traditionally performed via a transfemoral approach; however, this may not be feasible in all patients due to peripheral vascular disease. We present a case of BAV performed via bilateral transradial access utilizing simultaneous deployment of two angioplasty balloons.

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Innominate artery cannulation for arterial perfusion during aortic arch surgery

Abstract: Innominate artery perfusionis a safe and useful technique for aortic arch surgery.

Cited by 16 publications

References 21 publications

Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database

Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database

Management of thoracic aortic graft infections

Balloon aortic valvuloplasty via a bilateral trans-radial artery approach prior to transcatheter aortic valve replacement

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