The technique of cardiopulmonary bypass must frequently be altered to adjust to the specific needs of the patient. Several interesting conditions have recently been encountered in which it seemed desirable to maintain dual inflow perfusion utilizing 2 separate arterial cannulae, 1 supplying the upper and another the lower portions of the body. This technique is especially useful in those cases having an impedance to blood flow through the thoracic aorta. Although somewhat unusual, such problems are occasionally encountered as characterized by the patient with a Hufnagel valve in the descending aorta. In this instance the femoral artery alone would not be a suitable inflow site, inasmuch as blood could not pass through the valve in a reverse direction. Although the bypass could be accomplished through the left subclavian artery, this vessel may be too small to accommodate high flows. The problem may be easily resolved by using 2 inflow catheters,
ELLIS PR, KEE JL. Dual Inflow Perfusion for Cardiopulmonary Bypass. Arch Surg. 1963;86(2):218–221. doi:10.1001/archsurg.1963.01310080042010
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