Anatomic and flow dynamic considerations for safe right axillary artery cannulation Julia Hillebrand, MD, Moritz Anton Konerding, MD, PhD, Mathias Koch,

Slides:

Advertisements

Similar presentations

Lost in translation The Journal of Thoracic and Cardiovascular Surgery

Advertisements

Manuel J. Antunes, MD, PhD, DSc

Vascular Thoracic Outlet Syndrome

Opening and closing kinematics of fresh and calcified aortic valve prostheses: An in vitro study Farhad Bakhtiary, MD, Omer Dzemali, MD, Ulrich Steinseiffer,

Surgical approaches to apical thoracic malignancies

Chetan Pasrija, MD, Michael A. Mazzeffi, MD, MPH, Zachary N. Kon, MD

Definition of proximal anastomosis in the doors study

Vascular Thoracic Outlet Syndrome

A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without.

Results of a hybrid procedure for patients with proximal left subclavian artery stenosis and coronary artery disease Hao Hong, MD, Long Wu, MD, Chao.

Actual application of virtual angioscopy: Is it yet to come?

Julia Dumfarth, MD, Alan S. Chou, BA, Bulat A

Anomalous aortic origin of a coronary artery in the Ross operation: Attention to minor details averts major problems Igor E. Konstantinov, MD, PhD, FRACS

Improving health care by embracing Systems Theory

Jennifer Chung, MD, MSc, Maral Ouzounian, MD, PhD

Right internal thoracic artery or saphenous vein grafting

Intrinsic cardiac stem cells are essential for regeneration

Successful repair of coronary artery–pulmonary artery fistula with coronary artery disease and atrial septal defect in an adult Živojin S. Jonjev, MD,

Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy Alessandro Pardolesi, MD, Giulia Veronesi,

Surgery for acute type A aortic dissection

Abracadabra I, II…HeartMate 3?

Victor van Berkel, MD, PhD

William M. DeCampli, MD, PhD

Silvana Molossi, MD, PhD, Carlos M. Mery, MD, MPH

Functional mitral stenosis after mitral valve repair is a true anatomic problem that originates from the time of surgery Vincent Chan, MD, MPH, Thierry.

Multilevel data analysis: What? Why? How?

Harold L. Lazar, MD The Journal of Thoracic and Cardiovascular Surgery

The lord of the rings Antonio Miceli, MD, PhD

Vascular Thoracic Outlet Syndrome

Reconstruction of a resected subclavian vein by transposition of the ipsilateral internal jugular vein Michel Gonzalez, MD, Sébastien Déglise, MD, Hans-Beat.

Support Your Specialty

The assessment of cost effectiveness and the effectiveness of cost assessment in cardiothoracic surgery Vinay Badhwar, MD The Journal of Thoracic and.

It's not “just a shunt” but sometimes it should be…

Military surgeons just want to have fun

A first start for lung transplantation?

Giant pseudoaneurysm after proximal aortic surgery treated by means of redo axillary artery cannulation and use of an Endoclamp device Francois Dagenais,

Is it really dumb to leave a stump?

Jules Lin, MD The Journal of Thoracic and Cardiovascular Surgery

Get it right the first time

Joseph A. Dearani, MD, Michael J. Ackerman, MD, PhD

Igor E. Konstantinov, MD, PhD, Peter Pohlner, MB, BS, FRACS

Simultaneous relief of acute visceral and limb ischemia in complicated type B aortic dissection by axillobifemoral bypass Kyung Hwa Kim, MD, PhD, Jong.

Successful endovascular repair of symptomatic aberrant left subclavian artery arising from Kommerell diverticulum with the chimney technique Zhong Hai,

Perfusion and repair technique in acute aortic dissection with cerebral malperfusion and damage of the innominate artery Paul P. Urbanski, MD, PhD, Matthias.

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

The thoracoabdominal saga and heroes

Mediastinoscopy-assisted ligation of an aberrant right subclavian artery through a supraclavicular approach Narain Moorjani, MD, FRCS, Nancy Mohsen,

Patrick T. Roughneen, MD, Grant T. Fankhauser, MD, Abe DeAnda, MD

Ralph S. Mosca, MD The Journal of Thoracic and Cardiovascular Surgery

The origins of open heart surgery at the University of Minnesota 1951 to 1956 Richard A. DeWall, MD The Journal of Thoracic and Cardiovascular Surgery

Commentary: It's all about the distal

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

Brachial artery cannulation in type A aortic dissection operations

The future of cardiac surgery training: A survival guide

Minor postoperative morbidity should not be neglected

The continuing challenge of congenital heart disease in China

Axillary artery cannulation in type a aortic dissection operations

Ralph E. Delius, MD The Journal of Thoracic and Cardiovascular Surgery

Should it stay or should it go?

“The more things change…”: The challenges ahead

Why arch curvature affects arch resistance

Toward a more rational approach in treating type B aortic dissection

Apples remain apples NO matter what

Energized lung resections

Preoperative PFTs: The answer is blowing in the wind

The evolution of cardiothoracic critical care

Who should decide margin length in pulmonary excision of lung cancer?

Did you like Terminator 3 better than Terminator 2

Deciding how much to pay for effective care

Presentation transcript:

Anatomic and flow dynamic considerations for safe right axillary artery cannulation Julia Hillebrand, MD, Moritz Anton Konerding, MD, PhD, Mathias Koch, Tim Kaufmann, PhD, Ulrich Steinseifer, PhD, Anton Moritz, MD, PhD, Omer Dzemali, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 146, Issue 2, Pages 467-471 (August 2013) DOI: 10.1016/j.jtcvs.2013.02.023 Copyright © 2013 Terms and Conditions

Figure 1 Anatomic preparation of an 80-year-old subject. Dissection and arterial cannulation of the distal segment of the right AA with its relation to the VA (red pin), brachial plexus, and minor pectoralis muscle (margins are marked by solid lines). The cannula is inserted into the distal AA. The dashed lines describe the course of the SA. Because the major pectoralis muscle is not divided from the clavicle, the distal segment of the SA is hidden. BP, Brachial plexus; dAA, distal segment of the right axillary artery; mAA, middle segment of the right axillary artery; mPM, minor pectoralis muscle; pAA, proximal segment of the right axillary artery; SA, subclavian artery; VA, vertebral artery. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 467-471DOI: (10.1016/j.jtcvs.2013.02.023) Copyright © 2013 Terms and Conditions

Figure 2 Changes of the intravascular flow dynamics within the right VA depending on 2 different positions (position 1 = upper figure and 2 = lower figure) of the arterial cannula tip within the right SA, right VA, and right carotid artery. The color of the arrows shows the velocity. Position 1 demonstrates negative intravascular flow when the arterial cannula is positioned within the orifice of the right VA. rCA, Right carotid artery; rSA, right subclavian artery; rVA, right vertebral artery. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 467-471DOI: (10.1016/j.jtcvs.2013.02.023) Copyright © 2013 Terms and Conditions

Figure 3 Intravascular mass flow (L/min) depending on different distances (mm) of the arterial cannula tip. Negative distance values mean that the cannula's tip is already positioned beyond the VA's origin. The data show that a negative intravascular mass flow within the right VA can be observed when the cannula is directly positioned within the dexter VA origin or beyond that. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 467-471DOI: (10.1016/j.jtcvs.2013.02.023) Copyright © 2013 Terms and Conditions