Right Axillary Artery Cannulation With Approach Through the Deltoid-pectoral Groove Using a Side Branch Graft

Side-graft right axillary artery cannulation with a lateral anterior approach through the deltoid-pectoral groove, as shown in the video, is an easy technique to establish arterial inflow for cardio-pulmonary bypass in the treatment of type-A aortic dissections and aortic arch aneurysms.

Between October 2008 and November 2009, 18 patients underwent right axillary artery cannulation using this technique. Eleven patients had type-A dissection and 7 had aortic arch aneurysms.

Cardiopulmonary bypass was successfully established and maintained in all cases. Once deep hypothermic circulatory arrest was established, antegrade cerebral perfusion was delivered at a flow rate of 10 cc/kg/min snaring the innominate artery at the origin. Two patients experienced short term right hand paresthesia and one patient developed right upper extremity edema which resolved spontaneously in 24 hours. No other complications were encountered.