Direct innominate artery cannulation for selective antegrade cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery Vinay Garg,

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Presentation transcript:

Direct innominate artery cannulation for selective antegrade cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery Vinay Garg, BHSc, Dimitrios N. Tsirigotis, MD, PhD, Jeff Dickson, MD, Constantine Dalamagas, CPC, David A. Latter, MD, Subodh Verma, MD, PhD, Mark D. Peterson, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 148, Issue 6, Pages 2920-2924 (December 2014) DOI: 10.1016/j.jtcvs.2014.07.021 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Illustration of the surgical technique used in innominate artery cannulation. A, The innominate vein is isolated and retracted and the base of the innominate artery gently mobilized. Two purse-string sutures were placed on the anterior wall of the proximal innominate artery, and dilators and the cannula were inserted over a guidewire. B, Antegrade cerebral protection was initiated by clamping the base of the innominate artery and connecting the afferent limb of the cardiopulmonary bypass circuit to the pediatric venous cannula. C, After the distal anastomosis was completed, antegrade cerebral protection was discontinued, and the aortic line was connected to the 8-mm side limb. The graft was clamped distally and full cardiopulmonary bypass resumed. Proximal reconstruction was performed. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2920-2924DOI: (10.1016/j.jtcvs.2014.07.021) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Computed tomographic image demonstrating a tortuous innominate artery. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2920-2924DOI: (10.1016/j.jtcvs.2014.07.021) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions