[Axillary artery cannulation with a Dacron graft for surgery of the aortic arch and ascending aorta]. / Canulación axilar mediante prótesis de Dacron en cirugía del arco y la aorta ascendente.

Cannulation of the axillary artery is one possible means of establishing cardiopulmonary bypass during surgery of the ascending aorta and aortic arch. Use of a Dacron graft for cannulation has a number of advantages. In this article, we report our experience with this technique in seven consecutive patients in whom we performed an ascending aorta replacement. The associated procedures involved were aortic root reconstruction using David's procedure in two patients, the Bentall procedure in one, the hemi-arch technique in two, the complete arch and elephant trunk technique in one, aortic valve repair in one, and Valsalva sinus reconstruction in one. Circulatory arrest with antegrade cerebral perfusion was carried out in three cases. There was no in-hospital mortality, and there were no vascular or infectious complications related to axillary access. One patient presented with transient paresthesia of the brachial plexus. In all cases, cardiopulmonary bypass flow was adequate.

Canulación axilar mediante prótesis de Dacron en cirugía del arco y la aorta ascendente / Axillary artery cannulation with a Dacron graft for surgery of the aortic arch and ascending aorta

La canulación de las arterias axilares para instaurar la circulación extracorpórea es una alternativa en la cirugía del arco y la aorta ascendente. Su canulación mediante una prótesis de Dacron presenta ciertas ventajas. En el presente trabajo comunicamos nuestra experiencia con esta técnica en 7 pacientes consecutivos. En todos se realizó un recambio de la aorta ascendente. Se asociaron los siguientes procedimientos: reconstrucción de la raíz aórtica según técnica de David en 2 pacientes, intervención de Bentall en uno, hemiarco en dos, arco completo y trompa de elefante en uno, resuspensión de velos aórticos en uno y reconstrucción de senos de Valsalva en uno. Se realizó parada circulatoria con perfusión anterógrada en 3 casos. La mortalidad hospitalaria fue nula. No hubo complicaciones vasculares ni infecciosas del abordaje axilar. Un paciente presentó una parestesia transitoria por afección del plexo braquial. El flujo de la circulación extracorpórea fue adecuado en todos los casos

Cannulation of the axillary artery is one possible means of establishing cardiopulmonary bypass during surgery of the ascending aorta and aortic arch. Use of a Dacron graft for cannulation has a number of advantages. In this article, we report our experience with this technique in seven consecutive patients in whom we performed an ascending aorta replacement. The associated procedures involved were aortic root reconstruction using David's procedure in two patients, the Bentall procedure in one, the hemi-arch technique in two, the complete arch and elephant trunk technique in one, aortic valve repair in one, and Valsalva sinus reconstruction in one. Circulatory arrest with antegrade cerebral perfusion was carried out in three cases. There was no in-hospital mortality, and there were no vascular or infectious complications related to axillary access. One patient presented with transient paresthesia of the brachial plexus. In all cases, cardiopulmonary bypass flow was adequate

Endocavitary patch repair for a left ventricular pseudoaneurysm: an alternative approach.

We present a case of postinfarction posterolateral left ventricular wall pseudoaneurysm with severe mitral regurgitation and poor left ventricular function. The patient had New York Heart Association (NYHA) class IV heart failure at the time of surgery, which was performed on an emergency basis. The surgical approach included coronary revascularization, surgical posterior mitral leaflet detachment with patch closure of the pseudoaneurysm neck from inside of the left ventricular cavity followed by mitral valve reconstruction, and subsequent implantation of a mitral annuloplasty ring.