Ann Thorac Surg 2001;71:400
© 2001 The Society of Thoracic Surgeons
Correspondence
Innominate artery cannulation in patients with severe porcelain aorta: Reply
Michael K. Banbury, MDa
a The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F/25, Cleveland, OH 44195, USA
e-mail: banburm{at}ccf.org
To the Editor
The additional indication of porcelain aorta as described by Prifti and colleagues adds to the spectrum of indications for cannulation of the innominate artery. Their description of cannulation and internal balloon occlusion, after a short period of circulatory arrest, is similar to techniques that have been described in the past.
It is certainly a viable alternative when faced with the difficult clinical situation that they described. One of the pitfalls of this technique is removing the internal balloon occluder before closure of the aortotomy. There are commercially available internal balloon occluders that are placed directly through the aorta, and these also serve as the arterial cannula. This technique, however, requires a site for cannulation on the ascending aorta that is often not available with porcelain aorta.
As the diversity of surgical pathology broadens with time, we must continue to adapt by modifying cannulation and aortic occlusion techniques to safely conduct cardiac surgery.
