Arch versus femoral artery perfusion during cardiopulmonary bypass

Aortic arch perfusion is favored by most cardiac surgeons. Perfusion via the femoral artery is still used sporadically at reoperations for aneurysms of the ascending aorta, or for the institution of partial pump support in very sick patients prior to opening of the chest. Our over-all experience indicates that surgical complications occurred primarily in the group of patients perfused via the femoral artery. On the other hand, serious disturbance in cerebral perfusion, as determined by electroencephalogram (EEG) monitoring, occurred in 7 percent of the patients perfused via the arch and 3 percent of those perfused via the femoral artery, a difference that was not statistically significant. We continue to advocate aortic arch cannulation and EEG monitoring during cardiopulmonary bypass procedures.