Commentator Discussion: Safe and controlled technique of aortic cannulation for thoracoabdominal normothermic regional perfusion

You and your colleagues describe a safe and controlled technique for aortic cannulation in a depressurized ascending aorta using the Seldinger technique for thoracoabdominal normothermic regional perfusion.Your video very clearly demonstrates your technique.The concise steps of securing the aorta, the needle insertion, and cannulation and a flaccid aorta does present a technique that is safe and, importantly, easily reproducible.The entire recovery process is conducted in a controlled fashion thus ensuring safety of the allograft, safety for the recovery team, and maintaining respect for the donor's gift of life.I have 2 questions for you.Are there steps that you use aside from just aspirating blood to ensure that the cannula is in the lumen prior to initiating of thoracoabdominal normothermic regional perfusion?And the second is, how would one troubleshoot aortic hematoma or bleeding, in the event that it does occur?I commend you and your coauthors on a concise reproducible approach to thoracoabdominal normothermic regional perfusion in this high-stress donation after cardiac death recovery scenario.