Axillary venous drainage in redo aortic root surgery.

The axillary artery is an established alternative cannulation site for peripheral cardiopulmonary bypass (CPB). However, axillary vein cannulation is not as common. Here, we present our experience with an axillo-axillary CPB combined with a femoro-femoral CPB in redo aortic root replacement. The full-flow bypass was obtained with vacuum-assisted drainage and excellent decompression of the heart was achieved without left heart venting. Although only adhesions around the aortic root graft were dissected, a comfortable surgical field could be obtained with our CPB strategy. Axillary vessels were easy to expose with a small single skin incision. Cerebral protection could be achieved in both antegrade and retrograde fashion when the circulatory arrest was required for an additional arch procedure. Our strategy based on axillo-axillary and femoro-femoral CPB was effective and feasible in redo aortic root replacement. We consider that it simplified the complex aortic reoperation.