Central cannulation is safe in acute aortic dissection repair

Reece, T. Brett; Tribble, Curtis G.; Smith, Robert L.; Singh, Rishabh; Stiles, Brendon M.; Peeler, Benjamin B.; Kern, John A.; Krön, Irving L.

doi:10.1016/j.jtcvs.2006.09.059

Cited by 103 publications

(93 citation statements)

References 19 publications

(20 reference statements)

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“…Our early outcomes in the TAA group, 4.3% mortality and 11% stroke, are acceptable compared with other reports not only about FA cannulation, 25) and ascending cannulation, [15][16][17][18] but also with axillary cannulation, [8][9][10] in the treatment of AAAD. As described above, there are advantages and disadvantages to each cannulation technique.…”

Section: Discussionsupporting

confidence: 50%

“…13,14) Recently, direct cannulation into the dissected ascending aorta has been reported by several surgeons. [15][16][17][18] This technique can be performed rapidly without injury to the peripheral arteries, but there are concerns that it may increase the risks of rupture, extension of the dissection and malperfusion. TAA cannulation is an old technique that was initially described in the early 1970s.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Transapical Aortic Cannulation for Acute Type A Aortic Dissection

Suenaga

Sato

Fumoto

et al. 2015

ATCS

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consecutive patients with AAAD were underwent the ascending aortic replacement at Nagasaki Kouseikai Hospital. These patients were divided into two groups according to the cannulation site, FA cannulation (n = 34) and TAA cannulation (n = 46). Early and mid-term outcomes were compared between two groups. Result: Preoperative patient characteristics were almost comparable between groups. The time from skin incision to starting cardiopulmonary bypass (CPB) was significantly shorter in the TAA group (45 ± 16 vs 23 ± 5.1 min; P <0.001). There were no significant differences in post-operative cerebral infarction in two groups (17% versus 11%; P = NS). The operative mortality rate was 8.8% in FA group and 4.3% in TAA group (P = NS). During follow up (mean, 6.8 years), survival at 3 years and 5 years was 77.4% and 71.9% in TAA group and 76.3% and 73.8% in FA group, respectively. Conclusion: The postoperative morbidity and mortality between the two groups were almost the same. TAA cannulation for acute Type A aortic dissection is faster, easy and safe with acceptable early and mid-term outcome.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Impact of Transapical Aortic Cannulation for Acute Type A Aortic Dissection

Suenaga

Sato

Fumoto

et al. 2015

ATCS

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“…Central aortic cannulation to the ascending aorta in acute type A aortic dissection was introduced in the 2000s [10]. The theoretical advantages of this strategy are the achievement of antegrade perfusion and the short amount of time required to establish CPB [4].…”

Section: Resultsmentioning

confidence: 99%

Circumferential Acute Type an Aortic Dissection with Intimo-Intimal Intussusception: The Efficacy of Central Aortic Cannulation

Yamashita¹,

Tabayashi²,

Abe³

et al. 2017

J Clin Case Rep

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An 80-year-old woman suffered from acute chest pain and then exhibited cardiogenic shock. Transthoracic echocardiography revealed severe aortic regurgitation due to the intussusception of the intima. Computed tomography also showed the intussusception of the intima into the left ventricular outflow tract over the aortic valve and dissection involving the aortic root, aortic arch, and descending thoracic aorta. During surgery, echocardiography-guided central aortic cannulation was performed for the prompt establishment of cardiopulmonary bypass. The complete intimal tear was circumferentially located in the middle level of the ascending aorta. The proximal flap was inverted into the left ventricle, and the distal flap had been pushed into the aortic arch. Graft replacement of the ascending aorta was performed successfully, and the patient had an uneventful postoperative course.

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“…[12][13][14] Furthermore, the use of cannulation of the ascending aorta to treat acute aortic dissection has also been reported. 4,5,15,16) Some institutions (such as ours) use the Seldinger technique for artery puncture and cannulation, 15,17) while others use direct cannulation for ordinary open heart surgery. 5,16) Both methods have been reported to be useful.…”

Section: Intraoperative Parameter(s) (Table 2)mentioning

confidence: 99%

“…1,2) Although femoral artery cannulation has been traditionally performed, 3) central cannulation has recently been more favorably considered from the perspective of preventing malperfusion and embolism. 4) In addition, cannulation techniques such as axillary artery cannulation, direct ascending aortic cannulation, and transapical ascending aortic cannulation are gaining popularity. [5][6][7] We have historically performed transapical ascending aortic cannulation as a standard procedure to manage acute type A aortic dissection, 7) but we have recently used direct ascending aortic cannulation where possible because it is easier to perform.…”

Section: Introductionmentioning

confidence: 99%

Direct and Transapical Central Cannulation for Acute Type A Aortic Dissection

Wada

Matsumura

Minematsu

et al. 2014

Annals of Vascular Diseases

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Objective: The choice of cannulation site for the treatment of acute Stanford type A aortic dissection is much debated. We believe that central cannulation is quick to perform, easy to use, and safe to manage acute type A aortic dissection. Materials and Methods: We retrospectively investigated 26 cases of acute aortic dissection performed using two different central cannulation methods between April 2011 and March 2012. Direct ascending aortic cannulation was performed using the Seldinger technique in 20 patients, and transapical ascending aortic cannulation was performed in six patients in whom puncture was difficult. Results: Patients were 21-86 years old (mean age, 67 years). The surgical techniques used to treat aortic dissection were hemiarch repair in 21 patients and total arch replacement in 5 patients. The mean length of surgery was 393 min. One death (3.8%) was attributed to intestinal ischemia. Conclusion: During surgery for acute aortic dissection, central cannulation using either transapical or direct puncture can be performed quickly and safely, and satisfactory short-term outcomes can be obtained. Because acute aortic dissection can present with various conditions, there is no single perfect surgical or cannulation method; therefore, the choice of surgical procedure should be individualized for each patient.

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Central cannulation is safe in acute aortic dissection repair

Cited by 103 publications

References 19 publications

Impact of Transapical Aortic Cannulation for Acute Type A Aortic Dissection

Impact of Transapical Aortic Cannulation for Acute Type A Aortic Dissection

Circumferential Acute Type an Aortic Dissection with Intimo-Intimal Intussusception: The Efficacy of Central Aortic Cannulation

Direct and Transapical Central Cannulation for Acute Type A Aortic Dissection

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