Eyüp AVCI, Onursal BUĞRA, Ahmet DOLAOĞLU

Proximal Aort Cerrahisinde Innominate arter kanülasyonu

Giriş: Aort cerrahisi uygulamalarında kardiyopulmoner bypass için arteryel kanülasyon bölgesi hala tartışma konusudur. Son yıllarda antegrade akım sağlayan kanülasyon tekniklerinin retrograde akım sağlayan bölgelere göre sağ kalım ve nörolojik sonuçlar açısından daha faydalı olduğunun gözlenmesi üzerine innominate arter ve axiller arter kullanımını artırmıştır. Bu çalışmada aort cerrahisinde innominate arter kanülasyonu üzerine olan tecrübelerimizi paylaşmayı amaçladık. Yöntemler: Çalışmaya proximal aort cerrahisi nedeniyle cerrahi tamir yapılan 18 hasta dahil edilmiştir. Hastaların preoperatif , operatif özellikleri ve post-operatif sonuçlar değerlendirilmiştir. Bulgular: Çalışmaya dahil edilen hastaların ortalama yaşları 58.8±10.2 iken hastaların çoğunluğunu erkekler oluşturmaktaydı (%72). Eşlik eden bicuspit art kapak patolojisi 9 hastada bulundu (%50). Postoperatif mortalite iki iken hiçbir hastada cerrahi sonrası inme veya nörolojik defisit gelişmemiştir. Sonuçlar: Çalışma sonrasında aort cerrahisinde kardiyopulmoner bypass için innominate arter kullanımının güvenli ve etkili olduğunu savunmaktayız.

Cannulation of Innominate Artery during Proximal Aortic Aneurysm Repair

Objective: There are many debates for cannulation sites during aortic surgeries. The cannulation technique which isproviding antegrade flow is associated with better survival and neurological outcomes than retrograde flow. For thispurpose, innominate and axillary artery cannulation have been increasingly used for cardiopulmonary bypassrecently. We aimed to present our experience with innominate artery cannulation for cardiopulmonary bypass andantegrade selective cerebral perfusion during proximal aortic aneurysm repair.Methods: A total of eighteen patients with proximal aortic aneurysm underwent surgical repair were included into thestudy. Pre-operative patient’s charecteristis, surgical details and postoperative outcomes were investigated.Results: The mean age was 58.8±10.2 and majority of the patients were male (72%). Bicuspit leafletes was found in 9patients (50%). Two patients died in postoperative period. No stroke or new neurological deficit was seen afterprocedures.Conclusions: This study is emphasize that cannulation of innominate artery can be used in safe and effective duringaortic surgery.

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