Thorac Cardiovasc Surg 2013; 61(07): 581-583
DOI: 10.1055/s-0032-1327763
How to Do It
Georg Thieme Verlag KG Stuttgart · New York

Simple and Controlled Method to Avoid Hyperperfusion of the Right Arm Following Axillary Artery Cannulation for Extracorporeal Membrane Oxygenator Support

Nestoras Papadopoulos
1   Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang-Goethe University, Frankfurt am Main, Germany
,
Ali El-Sayed Ahmad
1   Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang-Goethe University, Frankfurt am Main, Germany
,
Spiros Marinos
1   Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang-Goethe University, Frankfurt am Main, Germany
,
Anton Moritz
1   Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang-Goethe University, Frankfurt am Main, Germany
,
Andreas Zierer
1   Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang-Goethe University, Frankfurt am Main, Germany
› Author Affiliations
Further Information

Publication History

05 March 2012

03 May 2012

Publication Date:
20 November 2012 (online)

Preview

Abstract

The right axillary artery has become the cannulation site of choice for establishment of extracorporeal membrane oxygenator support in many centers. Dissection and cannulation of this vessel are simple and safe in the majority of patients. Typically, a side graft is used to avoid malperfusion of the right arm. Although this protocol offers many advantages, a common complication is the critical hyperperfusion of the right arm. Subsequent compartment syndrome and decline of antegrade inflow of oxygenated blood, especially into the brain and coronary arteries, can be life threatening in such critical patients. We describe herein a simple yet effective and controlled technique to avoid this particular problem.