Hosono Mitsuharu, Shibata Toshihiko, Murakami Takashi, Sakaguchi Masanori, Suehiro Yasuo, Suehiro Shigefumi
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan.
Ann Thorac Cardiovasc Surg. 2016;22(2):84-9. doi: 10.5761/atcs.oa.15-00296. Epub 2016 Jan 15.
This retrospective study aimed to evaluate the results of our experience with axillary artery cannulation via a side graft in aortic valve replacement in patients with ascending aortic atherosclerotic disease.
From January 2002 to 2012, we operated on 76 patients for aortic valve disease with the use of the axillary artery for arterial inflow in our institute. The indications for cannulation of the axillary artery were aortic aneurysm in 37 patients, severe aortic atherosclerosis in 28 patients, and re do surgery in 11 patients.
Right axillary artery cannulation via a side graft provides sufficient antegrade aortic flow of 2.6 ± 0.1 L/m(2) during cardiopulmonary bypass. No additional arterial cannulation was necessary to obtain sufficient perfusion during cardiopulmonary bypass. Although permanent perioperative stroke was observed in two patients, this did not occur during the operation. There were no problems with cannulation or wound and graft infections. During the follow-up period, there were no thrombotic events due to an axillary graft stump in the right upper extremities.
Axillary artery cannulation via a side graft is a useful and safe option for cardiopulmonary bypass in patients with atherosclerotic disease of the ascending aorta undergoing aortic valve replacement.
本回顾性研究旨在评估我们在升主动脉粥样硬化疾病患者行主动脉瓣置换术时经侧支移植物进行腋动脉插管的经验结果。
2002年1月至2012年，我们在本机构对76例主动脉瓣疾病患者进行手术，使用腋动脉作为动脉流入道。腋动脉插管的适应证为：37例患者为主动脉瘤，28例患者为严重主动脉粥样硬化，11例患者为再次手术。
在体外循环期间，经侧支移植物行右腋动脉插管可提供2.6±0.1L/m(2)的充足顺行主动脉血流。在体外循环期间无需额外的动脉插管即可获得充足的灌注。虽然有2例患者出现永久性围手术期卒中，但并非发生在手术期间。插管、伤口及移植物感染均无问题。在随访期间，右上肢腋动脉移植物残端未发生血栓形成事件。
对于升主动脉粥样硬化疾病患者行主动脉瓣置换术时，经侧支移植物进行腋动脉插管是体外循环一种有用且安全的选择。
