Choice of venous cannulation for bypass during repair of traumatic ruptureof the aorta

Background. Choices for venous cannulation for left heart bypass, to assist repair of traumatic rupture of the thoracic aorta, are between the left at rial appendage and pulmonary veins. Methods. A retrospective chart review was performed of patients who underwe nt operative repair of ruptured aorta. Results. Over a 15-year period between March 1985 and February 2000, 133 pa tients were admitted to a level I trauma center with aortic rupture. Of the 50 procedures performed with left heart bypass, the left atrial appendage was cannulated in 19 and pulmonary veins in 31 (four superior, 27 inferior) . Complications occurred in 7 of the 19 patients who underwent venous cannu lation via the atrial appendage (two ventricular fibrillation, three atrial fibrillation, one pericardial effusion leading to tamponade, and one phren ic nerve injury). Complications occurred in 2 patients who underwent cannul ation via pulmonary vein (one atrial fibrillation, one pericardial effusion requiring tapping) (p = 0.02). Conclusions, Cannulation via the pulmonary veins is associated with a decre ase in complication rates compared with cannulation of the atrial appendage . (Ann Thorac Surg 2001;71:39-42) (C) 2001 by The Society of Thoracic Surge ons.