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Ann Thorac Surg 2005;79:e36-e38
© 2005 The Society of Thoracic Surgeons

Case report

Transaxillary Aortic Endoclamping for Ascending Aortic Pseudoaneurysm and Dissected Descending Aorta

Daniele Maselli, MD*, Francesco Musumeci, MD

Department of Cardiac Surgery, Azienda Ospedaliera S. Camillo-Forlanini, Rome, Italy

Accepted for publication March 25, 2004.

* Address reprint requests to Dr Maselli, Divisione di Cardiochirurgia, Azienda Ospedaliera S. Camillo-Forlanini, Circonvallazione Gianicolense 87, 00152 Rome, Italy (E-mail: dmaselli{at}tiscali.it).

Patients presenting with pseudoaneurysm of the aortic root close to the sternum, severe aortic regurgitation, and chronic dissection of the descending aorta represent a formidable surgical challenge. Closed chest circulatory arrest in this setting carries a high risk of myocardial or brain damage. We propose a modification of the port-access technique that allows control and access of the pseudoaneurysm, avoiding the need for closed chest circulatory arrest. Our strategy is based on transaxillary endoclamping of the ascending aorta and combines the advantages of antegrade aortic flow with the possibility of stopping the heart and venting the left ventricle before sternotomy.




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D. Maselli, G. Santise, A. Montalto, and F. Musumeci
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Ann. Thorac. Surg., October 1, 2005; 80(4): 1303 - 1308.
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