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Use of Axillary Cannulation for Simultaneous Endo-Occlusion and Antegrade Perfusion During Minimally Invasive Surgery

Farivar, Robert Saeid MD, PhD; Fernandez, Joss D. MD

Innovations: Technology & Techniques in Cardiothoracic & Vascular Surgery: May/June 2012 - Volume 7 - Issue 3 - p 201–203
doi: 10.1097/IMI.0b013e318264896a
Original Articles

Objective: We aimed to develop an antegrade arterial perfusion method that would allow a single suture line on the heart.

Methods: Using an 8-mm Dacron graft sewn to the right axillary artery, we performed antegrade arterial flow and simultaneous endo-occlusion, as well as the delivery of antegrade cardioplegia.

Results: Five patients underwent right axillary antegrade flow, with intention to use axillary endo-occlusion. There were no deaths, axillary artery injuries, or conversions to sternotomy. One patient who had a small (6 mm) axillary artery required femoral arterial balloon placement with axillary arterial flow. When using a 100-mm endoballoon, transesophageal echo alone is suitable for placement of the endoballoon. All patients are alive and doing well at least 1 year after surgery.

Conclusions: The right axillary artery is a suitable conduit for simultaneous endo-occlusion, antegrade flow, and antegrade cardioplegia delivery during mitral valve surgery.

From the Department of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Carver College of Medicine, Iowa City, IA USA.

Accepted for publication June 5, 2012.

Presented at the Annual Scientific Meeting of the 21st Century Cardiothoracic Surgical Society, February 17–19, 2011, Boca Raton, FL USA.

Disclosures: Robert Saeid Farivar, MD, PhD, is a consultant for Edwards Lifesciences, Irvine, CA USA. Joss D. Fernandez, MD, declares no conflict of interest.

Address correspondence and reprint requests to Robert Saeid Farivar, MD, PhD, University of Iowa Hospitals and Clinics, Carver College of Medicine, 200 Hawkins Drive, SE517GH, Iowa City, IA 52242 USA. E-mail:

Copyright © 2012 by the International Society for Minimally Invasive Cardiothoracic Surgery. Unauthorized reproduction of this article is prohibited.