Outcome with peripheral versus central cannulation in acute Type A dissection †

Interactive Cardiovascular and Thoracic Surgery
Stefan KlotzHans-Hinrich Sievers

Abstract

Acute aortic dissection type A (AADA) is still an emergency operation with high morbidity and mortality. In this acute situation quick cannulation to the heart-lung machine and systemic cooling is often life-saving. However, the often easy access to the femoral vessels for cannulation leads to an arterial backflow in the descending aorta with the likelihood of plaque rupture and cerebral embolism. We analysed the outcome after initial femoral versus central cannulation for AADA. All patients with acute aortic dissection type A operated between January 2003 and December 2012 were evaluated for the type of arterial cannulation (femoral vs central) for initial bypass. Demographic data and outcome parameters were accessed. No patient was excluded. One hundred and seventy-seven patients were operated on with acute type A dissection in the last 10 years; 94 (53.1%) were initially cannulated in the central aortic vessels and 83 (46.9%) in the femoral artery. The patients were comparable with regard to age (61.1 ± 14.9 vs 62.2 ± 15.0 years, P = 0.607), gender (male, 62 vs 69%, P = 0.348), EuroSCORE (11.5 ± 4.0 vs 12.8 ± 4.3, P = 0.057) and previous sternotomy (17% in both groups). Bypass (243 ± 105 vs 233 ± 83 min, P = 0.471), cross-cl...Continue Reading

References

Feb 16, 2010·Interactive Cardiovascular and Thoracic Surgery·Kaushal K TiwariMattia Glauber
Jan 21, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bartosz RylskiErnst Weigang
Sep 11, 2012·The British Journal of Surgery·T KrügerE Weigang
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Jul 13, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Zongli RenWanli Jiang

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Citations

May 30, 2015·Interactive Cardiovascular and Thoracic Surgery·Roberto Gaeta
Sep 22, 2016·General Thoracic and Cardiovascular Surgery·Tomonobu Abe, Akihiko Usui
Oct 14, 2016·Heart·Miriam SilaschiOlaf Wendler
Jan 23, 2017·The Annals of Thoracic Surgery·Feng GaoFangming Lin
Jul 14, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Akiko Tanaka, Anthony L Estrera
Sep 9, 2018·Asian Cardiovascular & Thoracic Annals·Evgeny RosseykinVladlen Bazylev
Feb 17, 2019·The Journal of Thoracic and Cardiovascular Surgery·Brad F RosinskiLars G Svensson

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