Axillary artery perfusion in acute type a aortic dissection repair

Abstract

ABSTRACTBackground:We evaluated our experience with axillary artery perfusion technique in acutetype A aortic dissection repair.Methods:Between September 2000 and July 2006, 41 consecutive patientswith acute type A aortic dissection underwent surgical repair. In 35 of 41 patients (85.4%), arterial perfusionwas performed through right axillary artery and in the remaining six patients (14.6%), arterial perfusion sitewas femoral artery. Indication for femoral artery perfusion was cardiac arrest and ongoing cardiopulmonaryresuscitation in one and pulslessness of right upper limb in five patients. Mean age was 54.9 ± 15.3 (16to 90 years) and 28 were male. Unilateral antegrade cerebral perfusion (perfusate temperature 22 to 25◦C)through axillary artery was performed in all axillary artery perfused patients and in three patients whohad femoral artery perfusion.Results:Five patients died postoperatively (hospital mortality 12.2%). All ofthem had evidence of single or multiple organ malperfusion preoperatively. We did not experience any newtransient or permanent neurologic deficit after the procedure in the unilateral antegrade cerebral perfusionpatients. Complications related to axillary artery cannulation were observed in two patients (5.3%). Onepatient with femoral artery cannulation experienced femoral arterial thrombosis, postoperatively.Conclu-sions:Right axillary artery cannulation for repair of acute type A aortic dissection is a simple and safeprocedure. In the case of pulslessness of right upper limb, femoral artery is still the choice of cannulationsite.