Peripheral vs. Central Cannulation in Cardiac Reoperations: Technical Considerations and Outcomes

Abstract

Objective To compare peripheral and central cannulation techniques in cardiac reoperation. Methods This retrospective study included 258 patients undergoing cardiac reoperation between January 2013 and July 2018. Patients were divided into two groups according to the cannulation type. The first group included 145 (56.2%) patients operated with standard central cannulation through aorta and right atrium or bicaval cannulation. In this group, cardiopulmonary bypass was instituted after sternotomy. The second group consisted of 113 (43.8%) patients operated with peripheral cannulation through femoral artery, vein, and internal jugular vein. In this group, cardiopulmonary bypass was started before sternotomy and after systemic heparinisation. The two groups’ operative complications and postoperative outcomes were compared. Results Procedure-related injury was higher in the central cannulation group than in the peripheral cannulation group (8.3% vs. 1.8%, respectively, P =0.038). Cardiopulmonary bypass time was shorter in the central cannulation group ( P =0.008) and total operation time was similar between the groups ( P =0.115). Postoperative red blood cell requirement was higher with central cannulation ( P =0.004). Operative mortality (2.8% vs. 0, P =0.186), hospital mortality (4.3% vs. 2.7%, P =0.523), and one-year survival rate (90.3% vs. 94.7%, P =0.202) were similar between the groups. Conclusion Peripheral cannulation reduces cardiac injury and blood transfusion in cardiac reoperation. The cannulation type does not affect postoperative complication, mortality, and one-year survival.

Tunneled right atrial two-stage cannulation in aortic surgery via ministernotomy

“…As known, if root enlargement is required in aortic valve surgery, exposure of the aortic root becomes a very important issue [3]. In minimally invasive cardiac surgery procedures, cannulation may also be performed via the peripheral vessels; on the other hand, completing the entire surgical procedure from a single incision has more satisfying clinical results [4].…”