The role of transapical cannulation in the operative management of acute aortic dissection

Djukanovic, BP; Mićović, Slobodan; Peric,; Milojević, P; Cirkovic, MV; Boricic, Mladen; Vuković, Petar

doi:10.1177/0267659114547380

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Currently, cannulation to establish cardiopulmonary bypass in patients with acute AD type A can be safely and efficiently performed through the femoral, subclavian, axillary artery, the ascending aorta, as well as through the left ventricular apex and the aortic valve [25,26,27]. Our results showed that axillar cannulation was associated with more frequent lethal outcome.…”

Section: Discussionmentioning

confidence: 66%

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

et al. 2021

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Introduction/Objective. Even with the current treatment mortality from aortic dissection remains high. The study aimed to evaluate the early postoperative outcome of patients with aortic dissection and identify which factors could have influence on it. Methods. The study included all consecutive patients who underwent surgery for acute aortic dissection type A from 2012 to 2017. We registered all parameters that could potentially impact the outcome (general data, medical history, clinical and cardiological diagnostic test findings, preoperative complications, type of cannulation and the operation performed, additional surgical procedures, operation duration, etc.). Patients were surgically treated according to the current protocols. The main outcome measures were complications and mortality during a one-month postoperative period. All data collected pre-, intra-, and postoperatively were compared and statistically analyzed. Results. The study included 246 patients, of an average 57.54+/-12.88 years of age and mostly male sex (74%). Early postoperative mortality occurred in 17% of patients. Preoperative chronic kidney insufficiency (p = 0.005) and cerebrovascular insult (p = 0.047) and tamponade (p = 0.036) were the major risk factors for postoperative complications and mortality. Long hypothermic cardiac arrest (p = 0.001), cross clamp (p = 0.017) and cardiopulmonary bypass time (p = 0.036) increased postoperative complications. Postoperative complications started occurring after ?33.5 minutes hypothermic cardiac arrest and ?67.5 minutes cross clamp time. Having more postoperative complications (p = 0.034) increased, while performing anterograde cerebral perfusion decreased the frequency of lethal outcome (p = 0.001). Conclusion. The majority of patients surgically treated for acute aortic dissection had good postoperative outcome. However, numerous pre-, intra- and postoperative factors can impact patient survival.

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Section: Discussionmentioning

confidence: 66%

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

et al. 2021

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“…Moreover, some surgeons declare that this technique could be achieved rapidly and safely and is easy to learn (19). Meanwhile, TAC can provide enough antegrade flow and secure true lumen perfusion (20,21).…”

Section: Transapical Aortic Cannulation (Tac)mentioning

confidence: 99%

Cannulation strategies in type A aortic dissection: a novel insight narrative review

Xia¹,

Cao²,

Xie³

et al. 2021

J Thorac Dis

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This review highlights vital details that can be easily overlooked and discuss how to identify and fix failed cannulation from another novel insight. Appropriate arterial cannulation strategy during cardiopulmonary bypass (CPB) in Stanford type A aortic dissection (AAD) is highly necessary to reach satisfactory perfusion effects and appreciable clinical outcomes. Despite several previously published reviews on cannulation strategies in AAD, most focus on the advantages and disadvantages by comparing various cannulation strategies. In fact, most of evidence came from retrospective studies. More importantly, however, some important details and novel approaches maybe overlooked due to variety reasons. These overlooked details also make sense in clinical practice. Papers related to cannulation refer to type AAD were retrieved and analyzed from the PubMed and Medline database. The key words such as "aortic dissection", "cannula", "cannulation", "cannulation strategy", "cerebral perfusion", "type I aortic dissection" were conducted and analyzed. In addition, we looked at some new and very significant specific perfusion techniques such as anterograde cerebral perfusion combined with retrograde inferior vena caval perfusion (RIVP) and reperfusion via the right carotid artery before surgery. The arterial cannulation site and strategy should be determined individually. Monitoring measures are very necessary in the whole procedure.

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Management of the Aortic Arch in Acute Aortic Dissection Type A

Kunihara

Schäfers

2021

Aortic Dissection and Acute Aortic Syndromes

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The role of transapical cannulation in the operative management of acute aortic dissection

Abstract: Routine transapical cannulation in patients with acute type A aortic dissection is a fast and safe way to establish cardiopulmonary bypass. There is no difference in major operative outcomes after transapical cannulation when compared to the other cannulation sites.

Cited by 4 publications

References 16 publications

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

Factors influencing early surgical outcomes of patients with acute aortic dissection type A

Cannulation strategies in type A aortic dissection: a novel insight narrative review

Management of the Aortic Arch in Acute Aortic Dissection Type A

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