Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
(a) Division of Cardio-Thoracic Surgery, Department of Medical Biotechnologies, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Multimed Man Cardiothorac Surg. 2022 Oct 14;2022. doi: 10.1510/mmcts.2022.075.
The choice of the arterial cannulation site has been a matter of debate over the years. The femoral artery has been used for a long time due to its ease of isolation and the possibility of percutaneous cannulation. However, it is associated with the risk of embolization because of the retrograde flow, and it is more dangerous in the case of aortic dissection because perfusion is unpredictable and retrograde flow exposes the patient to the risk of malperfusion. Cannulation of the axillary artery has recently gained popularity because of its advantages, in particular for antegrade aortic perfusion during cardiopulmonary bypass and for its ability to facilitate cerebral perfusion during hypothermic circulatory arrest. We show tips and tricks to facilitate the isolation and direct cannulation of the axillary artery because we think that this procedure should be practiced by all cardiac surgeons, even those who are just beginning their practices.
多年来，动脉插管部位的选择一直存在争议。股动脉由于易于隔离和经皮插管的可能性而长期被使用。然而，由于逆行血流，它与栓塞的风险相关，并且在主动脉夹层的情况下更危险，因为灌注是不可预测的，逆行血流使患者面临灌注不良的风险。由于其优势，最近腋动脉插管变得流行，特别是在体外循环期间进行顺行主动脉灌注，并且在低温循环停止期间有助于脑灌注。我们展示了一些技巧和窍门来方便腋动脉的隔离和直接插管，因为我们认为所有心脏外科医生都应该练习这个程序，即使是刚刚开始实践的医生。
