There is a trend towards cannulation of the axillary artery for extracorporeal circulation in patients requiring aortic arch surgery. We analyzed the published data comparing axillary and femoral cannulation for safety and outcome. End points were death; stroke, neurologic, and vascular complications; and malperfusion. Femoral cannulation is safe for extracorporeal circulation in patients witho...

The axillary arch is a muscle slip varying from 7 to 10 cm in length and 5 to 15 mm in breadth. It occasionally arises from the edge of the latissimus dorsi, at about the middle of the posterior fold of the axilla and crosses the axilla in front of the axillary vessels and nerves to join the under-surface of the tendon of the pectoralis major, the coracobrachialis, or the fascia over the biceps...

Knowledge of muscular, vascular, and neural variations in the axilla is of great clinical importance, especially in mastectomies, breast reconstruction, and axillary bypass operations. In the present paper, we report unilateral variations observed in the axillary region of a male cadaver. A fibromuscular axillary arch was observed on the right side. On the same side, there was a bifurcated axil...

BACKGROUND Cerebral protection and circulatory management remains a controversial issue in aortic arch surgery. The present study reported surgical outcomes of arch repair using moderate hypothermic circulatory arrest (MHCA) and unilateral selective antegrade perfusion (uSACP). METHODS From January 2004 and December 2012, 500 patients underwent hemiarch repair (HARCH) and 124 underwent total ...

Continuous attention has been developed on the anatomical variations of the axilla in anatomist and surgeon due to their clinical importance. The axillary region is an anatomical space between the lateral part of the chest wall and the medial aspect of the upper limb. During the routine dissection of embalmed cadavers, we found variant muscular slip originating from the lateral border of tendin...

OBJECTIVE The prevention of cerebral injury is an important consideration during the repair of an aortic arch aneurysm, and this is a major goal of cerebral protection techniques. We describe extended thoracic aortic aneurysms treated by use of our current surgical strategy. PATIENTS AND METHODS From January 2001 to June 2008, a total of 17 patients (12 men and 5 women; mean age 67.3 ± 7.3 yr...

Cannulation of the axillary artery is one possible means of establishing cardiopulmonary bypass during surgery of the ascending aorta and aortic arch. Use of a Dacron graft for cannulation has a number of advantages. In this article, we report our experience with this technique in seven consecutive patients in whom we performed an ascending aorta replacement. The associated procedures involved ...

BACKGROUND We investigated whether the axillary artery or ascending aorta cannulation combined with the arch first method decreases the risk of stroke during total arch replacement. PATIENTS AND METHODS From January 2002 to January 2006, 35 total arch replacements were performed with the arch first method and central arterial cannulation. The mean age was 66+/-10 years. The cannulation sites ...