Cannulation of the brachiocephalic trunk during surgery of the thoracic aorta: a simplified technique for antegrade cerebral perfusion

Abstract

Here we present our simplified technique of cannulation of the brachiocephalic trunk for cardiopulmonary bypass and antegrade cerebral perfusion institution.

How I do it – sole innominate cannulation for acute type A aortic dissection

“…Eusanio et al described the use of brachiocephalic trunk for providing antegrade cerebral perfusion during thoracic aortic surgery. The innominate artery was exposed from its origin to bifurcation and an 8 or 10 mm vascular graft anastomosed to it end to side while it was partially side clamped and the arterial line connected to the vascular graft [19]. They extended the same technique to provision of CPB and ACP in 55 patients requiring various forms of aortic surgery, only 1 of whom had acute dissection, and reported 3.6% hospital mortality and 1.8% temporary neurological dysfunction [20].…”

Direct innominate artery cannulation: An alternate technique for antegrade cerebral perfusion during aortic hemiarch reconstruction

“…Other groups have used a side graft sewn to the innominate artery to establish CPB. Di Eusanio and colleagues 14 reported outcomes in a series of 55 patients undergoing aortic replacement mainly for aneurysmal disease, where the innominate artery was partially clamped and a side graft was attached to the innominate artery 4 to 5 cm from its origin and used for both CPB and ACP. Hospital mortality was 3.6%, transient neurologic dysfunction rate was 1.8%, and stroke rate was zero.…”

Cannulation of the innominate artery during surgery of the thoracic aorta: our experience in 55 patients

“…Myocardial protection was achieved with blood cardioplegia. Details of our cannulation technique of the IA have been previously described [5]. Briefly, after the IA was exposed from its origin to the bifurcation, it was partially side-clamped 4-5 cm distal to its origin.…”

“…In 2004, we started to select the innominate artery (IA) as a site for cardio pulmonary bypass (CPB) arterial inflow and antegrade cerebral perfusion (ACP) when required [5]. In the present study, we present our experience with 55 patients.…”