Innominate Artery Graft Cannulation for Aortic Arch Surgery [1]
While graft cannulation of the axillary artery has become a standard approach for antegrade cerebral perfusion during aortic arch surgery, it is limited. The second incision can be morbid, with risk of injury to the brachial plexus. In addition, hyper-perfusion of the right upper extremity with a pressure gradient across the thoracic inlet is not uncommon, leading to spurious central pressure representation in a right radial artery. Graft cannulation of the innominate artery is an alternative to axillary cannulation that is done through the primary sternotomy incision. Graft cannulation is not associated with brachial artery injury, arm hyper-perfusion, or pressure gradients. The technique has been previously reported, and is documented to be safe and effective.