Innominate artery cannulation for proximal aortic surgery: outcomes and neurological events in 263 patients

Abstract

Innominate artery cannulation can be performed safely and poses a low risk of neurological events in procedures requiring hypothermic circulatory arrest. The technique for cannulating this artery should be part of the routine armamentarium of cardiac and aortic surgeons, and the innominate artery is among the preferred perfusion sites for delivering ACP.

Alternative cannulation techniques in surgical repair for acute type A aortic dissection

“…In their study, 27 (10.3%) patients had acute or subacute Type I aortic dissection. The mortality rate was 4.9% and postoperative stroke was 3.4% [9].…”

“…It also does provide more central flow, does carry a low risk of neurological complications, and does not require an additional skin incision during surgery. Preventza et al [9] cannulated the innominate artery with a side-graft in 263 patients undergoing the proximal aortic surgery. In their study, 27 (10.3%) patients had acute or subacute Type I aortic dissection.…”

Differential aspects of ascending thoracic aortic dissection and its treatment: the North American experience

“…Reportedly, both deep and moderate levels of hypothermia during the period of circulatory arrest have been used successfully (14)(15)(16)(17)22). Different cannulation strategies have been advocated (19,21,(23)(24)(25)(26)(27). Early application of the crossclamp during the cooling period has been reported (7,23), as has a clampless technique (15)(16)(17)(18)(19).…”

“…In hemodynamically stable patients, arterial inflow is established via an 8-mm Dacron graft into the innominate artery if the dissection does not extend into it, or via the Dacron graft into the right axillary artery (24). If the patient is in extremis, femoral artery cannulation is another alternative (depending on the body habitus), as is direct aortic cannulation.…”

Proximal arterial cannulation in thoracic aortic surgery—Literature review

“…The site of arterial cannulation for CPB is a strong determinant of postoperative neurological clinical outcomes . Each cannulation techniques discussed in this paper has certain advantages and disadvantages in its use.…”