Axillary Artery Cannulation in Acute Aortic Dissection: A Word of Caution

Baek, Wan Ki; Kim, Young Sam; Lee, Mina; Yoon, Yong Han; Kim, Joung Taek; Lim, Hyun

doi:10.1016/j.athoracsur.2015.06.054

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…By providing antegrade cerebral perfusion under hypothermic circulatory arrest, better neurological outcomes have been achieved [22, 26]. However, there are still several drawbacks associated with solitary axillary artery cannulation, including limited flow rate, greater technical demand, and intraoperative dissection of the innominate artery [7, 27, 28]. Therefore, we attempted to perform antegrade and retrograde arterial flow simultaneously to achieve optimal systemic perfusion and avoid these fatal shortcomings.…”

Section: Discussionmentioning

confidence: 99%

Double arterial cannulation strategy for acute type A aortic dissection repair: A 10-year single-institution experience

et al. 2019

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BackgroundRepair of acute type A aortic dissection (ATAAD) is a complex and emergent cardiovascular surgery that is associated with high perioperative morbidity and mortality. Each cannulation strategy has different benefits and drawbacks during cardiopulmonary bypass. Using a retrospective study design, we aimed to clarify the safety and efficacy of right axillary artery cannulation in combination with femoral artery cannulation compared to single arterial cannulation for ATAAD repair.MethodsFrom January 2007 to July 2017, 476 adult patients underwent ATAAD repair at a single institution. Patients were classified into groups according to their cannulation strategy: the double arterial cannulation (DAC) group (n = 377; 79.2%) or single arterial cannulation (SAC) group (n = 99; 20.8%). Preoperative demographics, surgical information, and postoperative recovery were compared between both groups. Survival and freedom from reoperation rates were analyzed using the Kaplan-Meier actuarial method.ResultsDemographics, comorbidities, and surgical procedures were generally homogenous between the two groups, except for sex, age, and rate of extensive aortic repair. Patients who underwent DAC had lower in-hospital mortality (13.5% vs. 25.3%; P = 0.005) and lower incidence of malperfusion-related complications (18.8% vs. 30.3%; P = 0.011) than those who underwent SAC. During multivariate analysis, SAC was identified as an in-hospital mortality predictor (odds ratio, 2.81; 95% confidence interval, 1.52–5.17; P = 0.001), as were preoperative ventilator support, intraoperative extracorporeal membrane oxygenation installation, and postoperative malperfusion-related complications. Three-year cumulative survival and freedom from reoperation rates were 74.8% and 85.3% for the DAC group and 62.6% and 81.1% for the SAC group, respectively (P = 0.010 and 0.430, respectively).ConclusionsWith acceptable short- and mid-term outcomes, DAC is effective and safe for establishing cardiopulmonary bypass during ATAAD repair.

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Section: Discussionmentioning

confidence: 99%

Double arterial cannulation strategy for acute type A aortic dissection repair: A 10-year single-institution experience

et al. 2019

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“…Therefore, new ND in patients with ATAAD may be unaffected by the choice of the arterial cannulation site [ 22 ]. Continuing axillary artery perfusion while ignoring aortic arch branch vascular abnormalities may result in CM and other catastrophic results [ 23 , 24 ]. Thus, to improve the existing treatment strategies, the key role of SABV in cerebral perfusion cannot be ignored.…”

Section: Discussionmentioning

confidence: 99%

Extra-anatomic revascularization and a new cannulation strategy for preoperative cerebral malperfusion due to severe stenosis or occlusion of supra-aortic branch vessels in acute type A aortic dissection

Sun¹,

Xue²,

Zhang³

et al. 2023

Heliyon

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“…Therefore, surgeons should be aware of an aortic anomaly at the time of cannulating the rSCA, especially with acute type A aortic dissection surgery. [12][13][14] Although several authors have described the positive impacts of rSCA cannulation, the mechanism of cerebral protection is still uncertain. Some have tried to evaluate the hemodynamics of the aortic arch when subclavian artery cannulation is used.…”

Section: Discussionmentioning

confidence: 99%

Computational fluid dynamics simulation of the right subclavian artery cannulation

Numata

Kawajiri

Yamazaki

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Axillary Artery Cannulation in Acute Aortic Dissection: A Word of Caution

Cited by 5 publications

References 8 publications

Double arterial cannulation strategy for acute type A aortic dissection repair: A 10-year single-institution experience

Double arterial cannulation strategy for acute type A aortic dissection repair: A 10-year single-institution experience

Extra-anatomic revascularization and a new cannulation strategy for preoperative cerebral malperfusion due to severe stenosis or occlusion of supra-aortic branch vessels in acute type A aortic dissection

Computational fluid dynamics simulation of the right subclavian artery cannulation

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