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Cardiac surgery has made significant progress since the advent of cardiopulmonary bypass. Arterial cannulation for bypass is a cornerstone to most cardiac procedures. Choosing an ideal cannulation site, employing peri-and intraoperative imaging, selecting an appropriate cannula, and avoiding complications are vital to success. These, along with the steps to arterial cannulation, are discussed in this chapter.

Splenic laceration and rupture are common phenomena among patients in a traumatic setting, especially in blunt trauma. Much more unusual, however, is splenic injury without a known insult. Several case reports and studies have been written about spontaneous splenic injury in patients with viral, haematological or malignant processes. Recently, we encountered a patient with a spontaneous splenic rupture and no preceding trauma apart from semielective cardioversion. Operative decision-making was complicated by the fact that he required systemic anticoagulation for atrial fibrillation. He eventually underwent splenectomy and made an uneventful recovery.