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

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.