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General Thoracic and Cardiovascular Surgery

Published in:

31-05-2022 | Heart Surgery | Original Article

Single direct right axillary artery cannulation using a modified Seldinger technique in minimally invasive cardiac surgery

Authors: Shuhei Nishijima, Yoshitsugu Nakamura, Daiki Yoshiyama, Yuto Yasumoto, Miho Kuroda, Taisuke Nakayama, Ryo Tsuruta, Yujiro Ito

Published in: General Thoracic and Cardiovascular Surgery | Issue 11/2022

Abstract

Objectives

Single direct right axillary artery cannulation is uncommon in minimally invasive cardiac surgery; however, the risk of cerebral infarction due to retrograde perfusion using the femoral artery remains high in patients with thoracoabdominal aortic atheroma. In our institution, we perform right axillary artery cannulation using a modified Seldinger technique in patients with atherosclerotic disease. This study aimed to evaluate the safety and effectiveness of this technique in minimally invasive cardiac surgery.

Methods

Data of all peripheral cannulation cases in patients who underwent minimally invasive cardiac surgery between March 2014 and December 2019 were obtained from our institutional database. Right axillary artery cannulation was successfully performed in 175 patients, 112 of whom underwent magnetic resonance imaging.

Results

Procedures comprised single-valve 86.3% (n = 151, 86.3%), double-valve (n = 21, 12%), and triple-valve (n = 3, 1.7%) surgeries. In-hospital mortality rate was 1.7% (n = 3). Stroke rate was 1.1% (n = 2); these 2 patients developed stroke at 3 and 5 days postoperatively. Forty-one (36.9%) patients were diagnosed with silent brain infarction on postoperative magnetic resonance imaging. There were no instances of intraoperative local axillary arterial injury, dissection, rupture, or surgical wound infection. Two patients had axillary wound hematoma and 2 had temporary right limb neuropathy, which resolved before discharge. No cases of pseudoaneurysm were found at the cannulation site. Limb ischemia and compartment syndrome were not reported.

Conclusions

There were no complications of postoperative symptomatic cerebral infarction following minimally invasive cardiac surgery with single direct right axillary artery cannulation using a modified Seldinger technique, even though patients had significant atherosclerotic vascular disease.

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Title: Single direct right axillary artery cannulation using a modified Seldinger technique in minimally invasive cardiac surgery
Authors: Shuhei Nishijima
Yoshitsugu Nakamura
Daiki Yoshiyama
Yuto Yasumoto
Miho Kuroda
Taisuke Nakayama
Ryo Tsuruta
Yujiro Ito
Publication date: 31-05-2022
Publisher: Springer Nature Singapore
Keywords: Heart Surgery
Heart Surgery
Published in: General Thoracic and Cardiovascular Surgery / Issue 11/2022
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-022-01832-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Single direct right axillary artery cannulation using a modified Seldinger technique in minimally invasive cardiac surgery

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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