Deltoido-pectoralis approach to axillary vessels for full-flow cardiopulmonary bypass

Zattera, Giuseppe; Totaro, Pasquale; D’Armini, Andrea Maria; Viganò, Mario

doi:10.1016/j.ejcts.2009.01.049

Cited by 7 publications

(14 citation statements)

References 6 publications

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“…Full‐flow CPB was achieved with vacuum assistance, and adequate decompression of the heart was obtained without left heart venting. Exposure of the axillary vein is relatively easy and both axillary artery and vein cannulation could be performed through a small single skin incision using the deltoid‐pectoralis approach …”

Section: Discussionmentioning

confidence: 99%

“…Both the axillary artery and vein were exposed using the deltoid-pectoralis approach. 3 Through a 6-cm long right subclavicular skin incision, the muscle fibers of the pectoralis major and the clavi-pectoral fascia were gently dissected. The axillary artery and vein were identified at the deltoid-pectoral groove.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Axillary artery cannulation for cardiopulmonary bypass (CPB) is an established alternative to femoral artery cannulation in thoracic aortic surgery for patients with a risk of retrograde perfusion . However, axillary venous drainage is rarely used . In cases of complex redo thoracic aortic surgery, a form of peripheral CPB should be established before sternal re‐entry.…”

Section: Introductionmentioning

confidence: 99%

“…At the time of surgery, hypothermic CPB was established before sternal re‐entry. Both the axillary artery and vein were exposed using the deltoid‐pectoralis approach . Through a 6‐cm long right subclavicular skin incision, the muscle fibers of the pectoralis major and the clavi‐pectoral fascia were gently dissected.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 However, axillary venous drainage is rarely used. 2,3 In cases of complex redo thoracic aortic surgery, a form of peripheral CPB should be established before sternal re-entry. Here, we present our clinical experience of axillo-axillary CPB in combination with femorofemoral CPB in a patient that underwent aortic root reoperation.…”

Section: Introductionmentioning

confidence: 99%

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Axillary venous drainage in redo aortic root surgery

et al. 2019

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The axillary artery is an established alternative cannulation site for peripheral cardiopulmonary bypass (CPB). However, axillary vein cannulation is not as common. Here, we present our experience with an axillo‐axillary CPB combined with a femoro‐femoral CPB in redo aortic root replacement. The full‐flow bypass was obtained with vacuum‐assisted drainage and excellent decompression of the heart was achieved without left heart venting. Although only adhesions around the aortic root graft were dissected, a comfortable surgical field could be obtained with our CPB strategy. Axillary vessels were easy to expose with a small single skin incision. Cerebral protection could be achieved in both antegrade and retrograde fashion when the circulatory arrest was required for an additional arch procedure. Our strategy based on axillo‐axillary and femoro‐femoral CPB was effective and feasible in redo aortic root replacement. We consider that it simplified the complex aortic reoperation.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Axillary venous drainage in redo aortic root surgery

et al. 2019

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Femoro-axillary cardiopulmonary bypass for giant abdominal aortic aneurysm repair prior to staged cardiac operation for ischaemic cardiomyopathy

Pocar

Moneta

Passolunghi

et al. 2010

European Journal of Cardio-Thoracic Surgery

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The optimal surgical management of simultaneous abdominal aortic aneurysm and cardiac disease remains a major challenge in case of larger aneurysms and severe cardiac disease. In case of symptomatic aneurysms or impending rupture, a single-stage combined operation is the most widely accepted procedure. We report the successful use of closed-chest cardiopulmonary bypass, with femoral venous and axillary arterial peripheral cannulation, to support cardiac function on the beating heart during resection of a giant abdominal aortic aneurysm and ischaemic cardiomyopathy. One month later, the patient underwent a second-stage deferred cardiac operation, consisting of triple coronary bypass grafting, undersized mitral annuloplasty and epicardial left ventricular lead implantation for cardiac resynchronisation therapy.

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Onion skin technique for open surgical replacement of aortic arch following primary endoprothesic thoracic aorta treatment

Totaro¹,

Raviola

Veronesi³

et al. 2013

European Journal of Cardio-Thoracic Surgery

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Endovascular aortic replacement (EVAR) techniques have become the first choice option for many aortic diseases in patients in whom standard open surgery was contraindicated or with high surgical risk. A secondary open surgical treatment, following a primary EVAR procedure, could, however, be challenging depending on the type, the extension and the position of primary endoprosthesis. Here, we describe an original and easy technique capable of simplifying a secondary aortic arch replacement following EVAR treatment of the descending thoracic aorta. The basic concept of such techniques is similar to that of the conventional 'elephant trunk' technique and is based on an inverted straight tube graft inserted into the endoprosthesis and anastomized using a multi-layer double suture with external strip felt of Dacron.

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Deltoido-pectoralis approach to axillary vessels for full-flow cardiopulmonary bypass

Cited by 7 publications

References 6 publications

Axillary venous drainage in redo aortic root surgery

Axillary venous drainage in redo aortic root surgery

Femoro-axillary cardiopulmonary bypass for giant abdominal aortic aneurysm repair prior to staged cardiac operation for ischaemic cardiomyopathy

Onion skin technique for open surgical replacement of aortic arch following primary endoprothesic thoracic aorta treatment

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