Axillary artery cannulation for cardiopulmonary bypass reduces cerebral microemboli

The Journal of Thoracic and Cardiovascular Surgery
Nasim HedayatiAlan H Markowitz

Abstract

Aortic cannulation for cardiopulmonary bypass (CPB) is linked to cerebral microemboli emanating from the ascending aorta. Aortic calcification or disease requiring replacement precludes aortic cannulation. Clinical experience with axillary artery cannulation led to the hypothesis that axillary cannulation may be cerebroprotective. Five mongrel dogs underwent a median sternotomy and isolation of the right axillary artery. The canine bicarotid brachiocephalic trunk was reconfigured by grafting the origin of the left carotid to the proximal left subclavian artery. Microspheres were injected into the ascending aorta during 4 conditions: before and after reconfiguration, CPB with aortic cannulation, and CPB with axillary cannulation. Brain, kidneys, and skeletal muscle were analyzed for microsphere distribution. Each animal served as its own control for comparison of aortic and axillary cannulation. No significant differences were documented in microsphere deposition for prereconfiguration and postreconfiguration. In the right middle cerebral artery distribution, 2300 +/- 710 microspheres per gram were deposited during aortic cannulation, compared with 540 +/- 110 during axillary cannulation (P <.05). In the left middle cerebral art...Continue Reading

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Citations

May 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·Yoshio Ootaki, Kiyotaka Fukamachi
Mar 5, 2013·Interactive Cardiovascular and Thoracic Surgery·Laura S FongManu N Mathur
Nov 12, 2005·Journal of Thoracic Imaging·Robert C GilkesonPeter Sachs
Jun 23, 2006·Anesthesia and Analgesia·Charles W HogueJoseph E Arrowsmith
Jul 18, 2006·The Heart Surgery Forum·Ihsan IskesenDeniz Selcuki
Sep 17, 2013·The Journal of Thoracic and Cardiovascular Surgery·Arudo HiraokaHidenori Yoshitaka
Sep 1, 2011·The International Journal of Cardiovascular Imaging·Vasco da Gama RibeiroMarco A Costa
Jul 23, 2013·The Journal of Thoracic and Cardiovascular Surgery·Julia HillebrandOmer Dzemali
Jan 23, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Satoshi NumataHitoshi Yaku
Dec 10, 2009·Radiologic Clinics of North America·Nila J AkhtarRobert C Gilkeson
May 26, 2009·The Journal of Thoracic and Cardiovascular Surgery·Hiroo TakayamaAllan S Stewart
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