Samurai cannulation (direct true-lumen cannulation) for acute Stanford Type A aortic dissection†

Kitamura, Tadashi; Torii, Shinzo; Kobayashi, Kensuke; Tanaka, Yuki; Sasahara, Akihiro; Ohtomo, Yuki; Horikoshi, Rihito; Miyaji, Kagami

doi:10.1093/ejcts/ezy066

Cited by 22 publications

(19 citation statements)

References 22 publications

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“…Recently, Kitamura et al conducted a similar comparison and reported reasonable stroke and mortality rates and no cannulation complications. 8 Group-A and B specific mortality was estimated to be 10% vs 30% and morbidity was (44.4% vs 57.1%), however, no statistical group difference was detected.…”

Section: Discussionmentioning

confidence: 81%

“…6,7 Yamamoto and Kitamura et al's comparison between direct TLC and other cannulation strategies reported no cannulation complications along with reasonable mortality and stroke rates. 8,9 Along with the scarcity of literature on aortic dissection in Pakistan, this new technique has only been recently introduced in the country at Aga Khan University Hospital. No study is available in Pakistan on this subject, while only sparse comparisons have been made worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…No study is available in Pakistan on this subject, while only sparse comparisons have been made worldwide. 8,9 Therefore, we aimed to compare demographic, clinical characteristics, peri-operative and the outcome variables of a newly established direct TLC technique with conventional techniques of cannulation during type-A dissection surgeries at our centre in Pakistan.…”

Section: Introductionmentioning

confidence: 99%

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Direct true lumen versus conventional cannulation for acute type a aortic dissection

Wahid¹,

Shahabuddin²,

Amanullah³

et al. 2020

J Pak Med Assoc

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Acute type-A aortic dissection is a surgical emergency and has a high rate of short-term mortality. Aortic dissection is highly under-reported in Pakistan. With the technological developments in its management, arterial cannulation technique of direct true lumen cannulation has emerged with improved outcomes. We aimed to compare the mortality and morbidity outcomes between direct true lumen and conventional cannulation techniques for arterial access in patients with acute type-A aortic dissection under a single-centre retrospective review from 2007 to 2017. Mean age of the participants was 43.3±11.6 vs 45±12.4 years with males being dominant in both groups. Frequency of overall morbidity was high in conventional cannulation group (Group-B), though it did not attain statistical significance, (p>0.999). Mortality rate was also high in Group-B (10% vs 30%), (p=0.582). Direct true lumen cannulation is an equally reliable option for establishing cardiopulmonary bypass due to reduced mortality and morbidity and may be given preference when dissection is extending into femoral and innominate arteries.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Direct true lumen versus conventional cannulation for acute type a aortic dissection

Wahid¹,

Shahabuddin²,

Amanullah³

et al. 2020

J Pak Med Assoc

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“…Methods to identify the true lumen included transesophageal echocardiography [26] or epiaortic ultrasound, but were time-consuming in emergency conditions or in the presence of circumferential aortic dissection or true lumen collapse [27]. Nevertheless, DTLC was shown to be safe and effective in patients with A-AAD [4,6,7,28,29], and restoring antegrade CPB perfusion was possible despite the complexity of the existing clinical scenarios, such as true lumen collapse, infrarenal aneurysm, peripheral vascular disease or obesity [6].…”

Section: Plos Onementioning

confidence: 99%

Direct true lumen cannulation in type A acute aortic dissection: A review of an 11 years’ experience

et al. 2020

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Objectives Direct true lumen cannulation (DTLC) of the aorta is an alternative cardiopulmonary bypass cannulation technique in the context of type A acute aortic dissection (A-AAD). DTLC has been reported to be effective in restoring adequate perfusion to jeopardized organs. This study reports and compares operative outcomes with DTLC or alternative cannulation techniques in a large cohort of patients with A-AAD. Methods All patients who underwent surgery for A-AAD between January 2006 and January 2017 in Mainz university hospital were reviewed. The choice of cannulation technique was left to the operating surgeon, however DTLC was our preference in patients who were in state of shock or showed signs of tamponade or hypoperfusion, in cases of potential cerebral malperfusion, as well as in patients who were under resuscitation. Results A total of 528 patients (63% males, mean age 64±13.8 years) underwent emergency surgery for A-AAD. The DTLC technique was used in 52.4% of patients. The DTLC group of patients had worse clinical status at the time of presentation with more shock, tamponade, true lumen collapse, cerebral and other malperfusion states. New neurologic events were diagnosed in around 8% of patients in each group following surgery, but there was a trend for quicker neurological recovery in the DTLC-group. Early mortality rates, short-term and long-term survival rates did not differ between the two groups. Conclusions DTLC is a safe cannulation technique that enables effective antegrade true lumen perfusion in complicated A-AAD scenarios, and is an advantageous addition to the aortic surgeons' armamentarium.

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“…Die Aorta kann auch direkt unter Sicht eröffnet und kanüliert werden [8]. Da die Aorta jedoch am unvorbereiteten, ungekühlten Patienten eröffnet wird, ist das Komplikationsrisiko als potenziell hoch einzustufen.…”

Section: Merkeunclassified

SOP Typ-A-Aortendissektion

Beckmann¹,

Martens²,

Shrestha³

2019

Kardio up

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Die akute Aortendissektion vom Typ A nach Stanford ist eine absolute Notfallsituation. Unbehandelt beträgt die Mortalität historisch etwa 50 % in den ersten 48 Stunden. Die unverzügliche Operation gilt als Therapie der Wahl und kann die Mortalität signifikant reduzieren. Dieser Artikel behandelt das perioperative Management sowie die verfügbaren Operationsverfahren. Darüber hinaus gehen wir auf speziell in unserer Klinik etablierte Besonderheiten und Empfehlungen ein.

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Samurai cannulation (direct true-lumen cannulation) for acute Stanford Type A aortic dissection†

Cited by 22 publications

References 22 publications

Direct true lumen versus conventional cannulation for acute type a aortic dissection

Direct true lumen versus conventional cannulation for acute type a aortic dissection

Direct true lumen cannulation in type A acute aortic dissection: A review of an 11 years’ experience

SOP Typ-A-Aortendissektion

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