Circumferential False Lumen Exclusion: A Technique for Indirect Cannulation of a Dissected Innominate Artery in Acute Type A Aortic Syndromes.

Indirect innominate artery (IA) cannulation provides important advantages of central arterial inflow and antegrade cerebral perfusion in proximal aortic surgery but is often avoided when the artery is dissected. We describe a stepwise technique enabling indirect cannulation of a dissected IA through circumferential false lumen exclusion and adventitia-true lumen reapproximation. In nine patients with dissected IA undergoing this approach, cannulation was successfully achieved without in-hospital mortality or permanent neurological deficit.