Outcome after aortic, axillary, or femoral cannulation for acute type A aortic dissection

The Journal of Thoracic and Cardiovascular Surgery

Zehang Chen¹  Maximilian Kreibich² 

[1] Department of Cardiovascular Surgery, Heart Center University Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa

关键词: type A aortic dissection;    cannulation;    central cannulation;    ascending aorta;   

DOI  :  10.1016/j.jtcvs.2018.11.100

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

ObjectiveThe optimal method for arterial cannulation in acute aortic dissection type A (ADA) remains controversial. The aim of this study was to compare central ascending aortic, axillary, and femoral cannulation in patients who underwent surgery for acute ADA.MethodsBetween 2006 and 2017, 584 patients were operated on for acute ADA. Of those, 355 (61%) underwent ascending aortic, 101 (17%) right axillary, and 128 (22%) femoral cannulation for arterial inflow. Clinical features and outcomes were compared after inverse probability weighting.ResultsAfter inverse probability weighting there were no statistical differences in preoperative characteristics. Operative details differed significantly among the 3 groups: hemiarch replacement was performed more often in the central aortic and the femoral group (P P P = .022) and aortic cross-clamp (P = .021) times were shortest in the aortic cannulation group and longest in the femoral cannulation group. Postoperative morbidities were similar; procedure-related stroke (P = .783) and the need for renal replacement therapy (P = .446). In-hospital mortality (P = .680) and long-term survival were similar (log rank, P = .704). Multilevel multivariate mixed effect logistic regression showed that the cannulation strategy was not associated with in-hospital mortality.ConclusionsCentral ascending aortic cannulation in patients with ADA can be used as safely as axillary or femoral cannulation, providing another option for quick and easy establishment of cardiopulmonary bypass.

【 授权许可】

Unknown