Axilloaxillary cardiopulmonary bypass: A practical alternative to femorofemoral bypass

被引:57
作者
Bichell, DP [1 ]
Balaguer, JM [1 ]
Aranki, SF [1 ]
Couper, GS [1 ]
Adams, DH [1 ]
Rizzo, RJ [1 ]
Collins, JJ [1 ]
Cohn, LH [1 ]
机构
[1] HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DIV CARDIAC SURG,BOSTON,MA 02115
关键词
D O I
10.1016/S0003-4975(97)00636-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Peripheral arterial and venous cannulation for cardiopulmonary bypass is used increasingly for patients undergoing minimally invasive cardiac operations, complex reoperations, or repair of aortic dissection or aneurysm, and for patients with extensive arteriosclerotic aortic disease in whom aortic cannulation is a prohibitive embolic risk. The common femoral artery and vein are most commonly used for peripheral cannulation, but these sites may be predisposed to complications, primarily because the femoral vessels are commonly involved with arteriosclerotic disease. We have recently begun to use the axillary artery and axillary vein as alternative cannulation sites, achieving full cardiopulmonary bypass, providing antegrade aortic flow, and avoiding many of the complications associated with other sites. Methods. Seven patients with peripheral vascular or aortic disease, or both, prohibiting safe aortic or femoral cannulation underwent cardiopulmonary bypass through axillary artery and axillary vein cannulation, approached through a small single subclavicular incision. Results. All patients were successfully cannulated and axilloaxillary cardiopulmonary bypass was possible without the need for additional cannulas. All auxiliary vessels were closed primarily without complication. Conclusion. For an expanding population of patients with peripheral vascular and aortic disease, axilloaxillary bypass is a safe and practical alternative to aortic or femoral cannulation. (C) 1997 by The Society of Thoracic Surgeons.
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收藏
页码:702 / 705
页数:4
相关论文
共 19 条
[1]  
Berger R L, 1973, Ann Thorac Surg, V15, P163
[2]  
BLAUTH CI, 1992, J THORAC CARDIOV SUR, V103, P1104
[3]   AXILLARY ARTERY FOR EXTRACORPOREAL-CIRCULATION [J].
BORST, HG .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 110 (06) :1775-1775
[4]   RIGHT THORACOTOMY, FEMOROFEMORAL BYPASS, AND DEEP HYPOTHERMIA FOR RE-REPLACEMENT OF THE MITRAL-VALVE [J].
COHN, LH ;
PEIGH, PS ;
SELL, J ;
DISESA, VJ .
ANNALS OF THORACIC SURGERY, 1989, 48 (01) :69-71
[5]   RETROGRADE AORTIC DISSECTION DURING CARDIOPULMONARY BYPASS [J].
EUGENE, J ;
ARONOW, WS ;
STEMMER, EA .
CLINICAL CARDIOLOGY, 1981, 4 (06) :356-359
[6]   STROKE FOLLOWING CORONARY-ARTERY BYPASS-GRAFTING - A 10-YEAR STUDY [J].
GARDNER, TJ ;
HORNEFFER, PJ ;
MANOLIO, TA ;
PEARSON, TA ;
GOTT, VL ;
BAUMGARTNER, WA ;
BORKON, AM ;
WATKINS, L ;
REITZ, BA .
ANNALS OF THORACIC SURGERY, 1985, 40 (06) :574-581
[7]   Thigh ischemia complicating femoral vessel cannulation for cardiopulmonary bypass [J].
Gates, JD ;
Bichell, DP ;
Rizzo, RJ ;
Couper, GS ;
Donaldson, MC .
ANNALS OF THORACIC SURGERY, 1996, 61 (02) :730-733
[8]  
GOLDING LAR, 1985, J THORAC CARDIOV SUR, V90, P626
[9]  
Knight J L, 1987, J Card Surg, V2, P343, DOI 10.1111/j.1540-8191.1987.tb00192.x
[10]   ADJUNCTS TO REDUCE THE INCIDENCE OF EMBOLIC BRAIN INJURY DURING OPERATIONS ON THE AORTIC-ARCH [J].
KOUCHOUKOS, NT .
ANNALS OF THORACIC SURGERY, 1994, 57 (01) :243-245