Standard atriocaval bypass cannulation starts with 2 purse-string sutures on the distal ascending aorta, pledgeted or not according to the aortic wall quality and surgeon’s preference. Two right atrial purse strings, one around the atrial appendage and one above the inferior vena cava, are followed by the cardiopulmonary bypass cannulation: first the aortic cannula, then the cannula for the retrograde cardioplegia, and finally the venous cannula. Once the circulation is guaranteed, the right superior pulmonary vein is exposed and a purse string for the left ventricular vent is performed, followed by the vent positioning. Finally, an aortic root purse string is used to secure an aortic root vent.
Cardiopulmonary bypass cannulation (bicaval)