Abstract
Background. The aim of this study was to evaluate the efficacy and
safety of innominate artery cannulation strategy with side graft
technique in proximal aortic pathologies. Methods. A total of 70
patients underwent innominate artery cannulation with a side graft for
surgery on the proximal aorta from 2012 to 2020. There were 46 men and
24 women with an avarage age of 56 ±13 years. The indications of surgery
were type A aortic dissection in 17 patients (24.3%), aortic aneurysm
in 52 patients (74.3%) and ascending aorta pseudoaneurysm in 1 patient
(1.4%). The innominate artery was free of disease in all patients.
Hypothermic circulatory arrest with antegrade cerebral perfusion was
utilized in 60 patients (85.7%). 3 patients had previous sternotomy
(4.2%). The most common surgical procedure was ascending aorta and
hemiarch replacement in 34 patients (48.5%). Results. The mean cardiac
ischemia and cardiopulmonary bypass times were 116+46 minutes and164+56
minutes, respectively. The mean antegrade cerebral perfusion time was
27+14 minutes. The patients were cooled between 22’C and 30’C during
surgery. 30-day mortality rate was 7.1% with 5 patients. 1 patient
(1.4%) had stroke, 1 patient (1.4%) had temporary neurologic deficit
and 8 patients (11.4%) had confusion and agitation that resolved
completely in all cases. There was no local complication or arterial
injury was encounterd. Conclusions. Cannulation of the innominate artery
with side graft is safe and effective for both cardiopulmonary bypass
and antegrade cerebral perfusion. This technique provides excellent
neurologic outcomes for proximal aortic surgery.