Retrograde cerebral perfusion through antero-axillary thoracotomy in the aortic arch surgery

Abstract

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.