Direct Versus Side Graft Cannulation From the Right Axillary Artery in Thoracic Aortic Surgery

Puiu, Paul; Pingpoh, Clarence; Beyersdorf, Friedhelm; Czerny, Martin; Keyl, Cornelius; Kreibich, Maximilian; Kondov, Stoyan; Rylski, Bartosz; Zimmer, Emmanuel; Siepe, Matthias

doi:10.1016/j.athoracsur.2020.12.022

Cited by 18 publications

(10 citation statements)

References 12 publications

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“…In addition, this technique may exacerbate further malperfusion or arch disruption when occurring dissection in the originating part of innominate or subclavian artery. Moreover, some studies (21,23,27) have shown that side-graft cannulation has less neurological dysfunction and cannulation-related complications. In addition, the axillary artery may be fragile and small caliber (26), which is unsuitable for direct cannulation or transfer to sidegraft cannulation when fail to direct cannulation.…”

Section: Discussionmentioning

confidence: 99%

“…Neurological dysfunction included permanent and contemporary neurological dysfunction. Cannulationrelated complications (21,23) included brachial plexus injury, iatrogenic axillary artery dissection, aortic dissection, axillary…”

Section: Data Extraction and Outcomesmentioning

confidence: 99%

“…First, the ten included cohort studies did not report long-term survival outcomes; Therefore, long-term results should be considered. paying more attention to some additional important clinical results, such as blood product requirements (23), the incidence of respiratory insufficiency and the incidence of sepsis, because Sabik et al (21) reported that the most common comorbidities were respiratory insufficiency and sepsis, which could cause a poor prognosis and increase the therapy cost. Finally, to strengthen the evidence of meta-analysis, randomized control trials with well-performed and large-scale are need.…”

Section: Study Limitationsmentioning

confidence: 99%

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Comparison of Post-operative Outcomes Between Direct Axillary Artery Cannulation and Side-Graft Axillary Artery Cannulation in Cardiac Surgery: A Systematic Review and Meta-Analysis

Xie

Liu

Yang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThere is a growing perception of using axillary artery cannulation to improve operative outcomes in cardiopulmonary bypass surgery. Two techniques, direct cannulation or side-graft cannulation, can be used for axillary artery cannulation, but which technique is better is controversial.MethodsA meta-analysis of comparative studies reporting operative outcomes using direct cannulation vs. side-graft cannulation was performed. We searched the PubMed, EMbase, Web of Science, and Cochrane Library. Outcomes of interest were neurological dysfunction, cannulation-related complications and early mortality. The fixed effects model was used.ResultsA total of 1,543 patients were included in the final analysis. Direct cannulation was used in 846 patients, and side-graft cannulation was used in 697 patients. Meta-analysis showed a higher occurrence of neurological Complication in direct cannulation group [odds ratio, 1.45, 95% CI (1.00, 2.10), χ2 = 4.40, P = 0.05] and a significantly higher incidence of cannulation-related complications in the direct cannulation group [odds ratio, 3.12, 95% CI (1.87, 5.18), χ2 = 2.54, P < 0.0001]. The incidence of early mortality did not have a difference [odds ratio, 0.95, 95% CI (0.64, 1.41), χ2 = 6.35, P = 0.79].ConclusionsThis study suggests that side-graft axillary artery cannulation is a better strategy as it reduces the incidence of neurological dysfunction and cannulation-related complications.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022325456.

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Section: Discussionmentioning

confidence: 99%

Section: Data Extraction and Outcomesmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

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Comparison of Post-operative Outcomes Between Direct Axillary Artery Cannulation and Side-Graft Axillary Artery Cannulation in Cardiac Surgery: A Systematic Review and Meta-Analysis

Xie

Liu

Yang

et al. 2022

Front. Cardiovasc. Med.

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“…In a recent study, it was found that stroke was seen more frequently (14.7% vs. 7.9%) in patients who underwent direct axillary artery cannulation compared to patients who used the side-graft technique. 13 However, on the contrary, it is stated that the type of cannula used in direct axillary cannulation may also affect the risk of cerebrovascular event. 14 In other words, what kind of axillary cannula is used and how the cannula is placed are also important.…”

Section: Should We Follow the Patients With Intraoperative Low Hemato...mentioning

confidence: 99%

“…There are still debates about how this cannulation should be performed. In a recent study, it was found that stroke was seen more frequently (14.7% vs. 7.9%) in patients who underwent direct axillary artery cannulation compared to patients who used the side‐graft technique 13 . However, on the contrary, it is stated that the type of cannula used in direct axillary cannulation may also affect the risk of cerebrovascular event 14 .…”

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confidence: 99%

Intraoperative nadir hematocrit as a poor outcome predictor after acute type A aortic dissection surgey

Yavuz

Engin

2022

Journal of Cardiac Surgery

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Acute type A aortic dissection is a life‐threatening disease associated with high morbidity and mortality that requires urgent surgical intervention. Hemodilution is inevitable in cardiac operations performed with cardiopulmonary bypass, which leads to nadir hematocrit levels. Studies have shown that nadir hematocrit levels are associated with poor postoperative outcomes. The management strategy of intraoperative anemia in these operations is still controversial. Should we follow the patients with intraoperative low hematocrit values or should we transfuse them? In addition to intraoperative nadir hematocrit, cannulation strategies play an important role in early postoperative outcomes after aortic dissection surgery.

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Peripheral Cannulation

Balaram

Bassin

2023

Cardiac Surgical Complications

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Direct Versus Side Graft Cannulation From the Right Axillary Artery in Thoracic Aortic Surgery

Cited by 18 publications

References 12 publications

Comparison of Post-operative Outcomes Between Direct Axillary Artery Cannulation and Side-Graft Axillary Artery Cannulation in Cardiac Surgery: A Systematic Review and Meta-Analysis

Comparison of Post-operative Outcomes Between Direct Axillary Artery Cannulation and Side-Graft Axillary Artery Cannulation in Cardiac Surgery: A Systematic Review and Meta-Analysis

Intraoperative nadir hematocrit as a poor outcome predictor after acute type A aortic dissection surgey

Peripheral Cannulation

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