Resuscitating the Chimney Graft to Innominate Artery for Straightforward Cannulation During Infancy

Ann Thorac Surg. 2020 May;109(5):e379-e381. doi: 10.1016/j.athoracsur.2019.11.053. Epub 2020 Jan 24.

Abstract

Arterial cannulation with a chimney polytetrafluoroethylene graft to the innominate artery is commonly used for antegrade cerebral perfusion during neonatal aortic arch surgery. When properly retained and prepared before sternal closure, resuscitation of the polytetrafluoroethylene graft to innominate artery can be performed months later during sternal reentry. It is a safe and reproducible technique for expeditious arterial cannulation at stage II palliation in single-ventricle patients or complete intracardiac repair of biventricular lesions. We report our experience utilizing this technique successfully during reoperation in 90 of 92 patients, with no adverse thromboembolic events identified.

MeSH terms

  • Aorta, Thoracic / abnormalities
  • Aorta, Thoracic / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Brachiocephalic Trunk / surgery*
  • Brain / blood supply*
  • Catheterization / methods*
  • Humans
  • Infant, Newborn
  • Norwood Procedures*
  • Palliative Care
  • Polytetrafluoroethylene*
  • Postoperative Complications / prevention & control
  • Reoperation
  • Thromboembolism / prevention & control

Substances

  • Polytetrafluoroethylene