Prolonged cannulation of the left internal mammary artery (LIMA) for blood pressure monitoring in a child after cardiopulmonary bypass

Cannulation of the radial artery percutaneously or by cut down is frequently used to monitor blood pressure in infants and children undergoing cardiopulmonary bypass. When radial artery cannulation is difficult because of previous cannulation attempts, and/or surgical cut downs, posterior tibial artery cannulation is sometimes undertaken. We describe a child in whom the left internal mammary artery (LIMA) was chosen for monitoring arterial blood pressure because of malfunction of the existing posterior tibial arterial pressure line after cardiopulmonary bypass. This line was used for more than 3 weeks postoperatively in the intensive care unit for monitoring and for sampling. There were no complications with the placement and/or the removal of this arterial line on the 25th postoperative day. When standard arterial monitoring sites are not accessible, internal mammary artery cannulation can provide reliable access for prolonged arterial blood pressure monitoring in the postoperative period in children.