| Axillary versus femoral cannulation for aortic surgery: enough evidence for a general recommendation? | |
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MedLine Citation:
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PMID: 17307506 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is a trend towards cannulation of the axillary artery for extracorporeal circulation in patients requiring aortic arch surgery. We analyzed the published data comparing axillary and femoral cannulation for safety and outcome. End points were death; stroke, neurologic, and vascular complications; and malperfusion. Femoral cannulation is safe for extracorporeal circulation in patients without aortic arch surgery. In patients with type A dissections, malperfusion may occur owing to retrograde perfusion of the false lumen and subsequent occlusion of the origin of the supra aortic vessels. Cannulation of the axillary/subclavian artery results in antegrade flow, at least in the right carotid artery, with the possibility of antegrade cerebral perfusion during aortic arch repair. There was a trend towards improved neurologic outcome when the axillary artery was used for extracorporeal circulation in such patients. When different techniques were compared, the use of a side graft for axillary cannulation reduced the complication rate. The lack of randomized trials and the high variety of inclusion criteria in the different studies do not allow a general recommendation for the use of the axillary artery as cannulation site. |
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Authors:
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Helmut Gulbins; Anita Pritisanac; Jürgen Ennker |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 83 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-19 Completed Date: 2007-03-30 Revised Date: 2008-09-19 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1219-24 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Surgery, Heart Center Lahr, Lahr/Schwarzwald, Germany. helmut.gulbins@heart-lahr.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aorta, Thoracic
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surgery* Arteries Axilla / blood supply* Catheterization* Extracorporeal Circulation / methods* Femoral Artery* Humans |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2008 Sep;86(3):1057-8; author reply 1058
[PMID:
18721629
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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