Axillary artery cannulation for aortic valve replacement through right anterior minithoracotomy
| Autor: | Laurence Gautier, Olivier Fabre, Ilir Hysi, Laurent Guesnier |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment medicine.disease Cannula law.invention Surgery medicine.anatomical_structure Aortic valve replacement Axillary artery law Median sternotomy medicine.artery Internal medicine Ascending aorta Cardiopulmonary bypass Cardiology medicine Thoracotomy Cardiology and Cardiovascular Medicine business Thoracic wall |
| Zdroj: | International Journal of Cardiology. 177:664-665 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2014.09.171 |
| Popis: | Median sternotomy remains the standard approach for aortic valvereplacement (AVR). In the late 90s, AVR was reported through upperministernotomy [1] or right anterior minithoracotomy [2]. The latterwas recently shown as significantly reducing postoperative outcomes[3,4]. Currently inthistechnique,cardiopulmonary bypass(CBP)isusu-ally established by femoral or ascending aortic arterial cannulation.Here, we report a new approach of conducting CBP by cannulation ofthe right axillary artery and discuss its potential advantages.Before surgery, patients underwent a body contrast-enhanced CTscan. We considered patients suitable for right anterior minithoracotomyif at the level of the main pulmonary artery: (i) N50% of the ascendingaorta lied out of the right sternal border and (ii) the distance betweenthe ascending aorta and the thoracic wall was less than 10 cm [3].Patients were positioned supine and intubated with a single-lumenendotracheal tube. Defibrillator pads were placed on the chest wall.CPB was established between a venous active drainage 29 Frenchdouble-stage atrial cannula, passed through the thoracotomy and theright axillary artery dissected through a 3 to 5-cm skin incision at thelevel of the delto-pectoral groove (Fig. 1).A 76-year-old female patient, without significant previous medicalhistory,wasreferredtoourdepartme ntwithdyspneacausedbyanaorticcalcifieddegenerativestenosis.ShehadapreservedLVfunction,anaorticsurface area of 0.7 cm |
| Databáze: | OpenAIRE |
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