Axillary artery cannulation in acute aortic dissection: a word of caution

초록

Arterial cannulation into the right axillary artery has become a commonly adopted strategy in the treatment of acute aortic dissection. Here we describe a case of acute aortic dissection with undetected aberrant right subclavian artery. An emergency operation was proposed in 41-year-old male for acute type A aortic dissection. A right axillary artery cannulation was preferred for arterial perfusion. Soon after beginning cardiopulmonary bypass, the femoral pressure dropped near zero. The arterial line was swiftly changed into the left femoral artery and maintained well throughout the operation. The follow-up computed angiogram(CT) revealed right aberrant subclavian artery, which was hardly detectable at the preoperative CT taken at the secondary hospital; non–enhanced and composed of cuts in rough section. Surgeons should be aware of the aortic arch anomaly whenever undergoing axillary artery cannulation.