Just a quick comment: cannulating the innominate artery does nothing to prevent cardiac injury upon re-entry, it just offers an option for the aortic pipe IN CASE OF CARDIAC INJURY-we still have to divide the sternum and mostly introduce bicaval cannulae.
I do not see how access for cannulation via the suprasternal notch is safer than redo sternotomy-the tissues are already adhered given the previous sternotomy, particularly where thymectomy and innominate cannulation have taken place in the first operation.The same applies to cavoatrial cannulation without sternotomy-a video showing the technique would be illuminating!
Reservations on SAC
29 August 2008
Just a quick comment: cannulating the innominate artery does nothing to prevent cardiac injury upon re-entry, it just offers an option for the aortic pipe IN CASE OF CARDIAC INJURY-we still have to divide the sternum and mostly introduce bicaval cannulae.
I do not see how access for cannulation via the suprasternal notch is safer than redo sternotomy-the tissues are already adhered given the previous sternotomy, particularly where thymectomy and innominate cannulation have taken place in the first operation.The same applies to cavoatrial cannulation without sternotomy-a video showing the technique would be illuminating!
Kindest Regards
Aristotle D Protopapas MSc. FRCS
Competing interests
none