Objective: We have recently found that left antero-axillary thoracotomy provides an ideal view of aortic arch and makes the direct cannulation to superior vena cava possible for retrograde cerebral perfusion during circulatory arrest. Method: Twelve patients with distal aortic arch aneurysm or aortic dissection underwent the repair of aortic arch through this approach. Mean duration of retrograde cerebral perfusion was 41 min. Results: Two hospital deaths occurred due to respiratory failure and stroke. The remaining patients survived without any neurological deficits. Conclusion: Antero-axillary thoracotomy may be an ideal approach which combines the advantages of median sternotomy and postero-lateral thoracotomy.
Sasaguri, S., Yamamoto, S., Fukuda, T., & Hosoda, Y. (1997). Retrograde cerebral perfusion through antero-axillary thoracotomy in the aortic arch surgery. European Journal of Cardio-Thoracic Surgery, 11(4), 657–660. https://doi.org/10.1016/S1010-7940(96)01135-9