Cannulation of the innominate artery for surgery of acute thoracic aortic aneurysm (surgical movie)

We present a new simplified technique for arterial cannulation of the innominate artery for extracorporal circulation in thoracic aneurysms. Access is gained via a minor enlargement of a standart median sternotomie. First, with the pericardium still closed, incision of the innominate artery superior to the innominate vein is performed. After heparin is given a 20–22 French straight aortic cannula is inserted and the flow directed to the aortic arch. Later for inspection or replacement of the arch the cannula is again turned by 180 degrees and the flow reduced to 1–1.5l/min at 28°C while the artery is clamped and the arch opened. For reperfusion the same cannula is left in place and again turned by 180 degrees in order to achieve a direct antegrade flow.