Does arterial cannulation site for aortic dissection repair impact surgical outcomes?

Lemaire, Anthony; Levine, Dov; Chao, Joshua; Sabatino, Marlena E.; Ikegami, Hirohisa; Takebe, Manabu; Russo, Mark J.; Lee, Leonard Y.

doi:10.21037/jtd-22-576

Cited by 4 publications

(1 citation statement)

References 22 publications

(35 reference statements)

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“…After the removal of duplicate entries and the exclusion of studies that did not meet the eligibility criteria, [1][2][3]9,[19][20][21][22][23][24][25] a total of 11 studies were selected for our analysis, encompassing a total of 7204 patients (with 2760 in the AoC group and 4444 in the AxC group, as detailed in Table 1). The selection process for these studies is depicted in the flow diagram in Figure 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

Aortic versus axillary cannulation in acute type A aortic dissection repair: A meta-analysis

Yamashita,

Sicouri,

Dokollari

et al. 2024

Asian Cardiovasc Thorac Ann

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Background Research comparing the effectiveness of central aortic cannulation to axillary artery cannulation in repairing acute type A aortic dissection is limited and controversial. This meta-analysis aimed to compare early outcomes of central aortic cannulation versus axillary artery cannulation for surgery for acute aortic dissection type A. Methods A comprehensive systematic search was conducted across PubMed/MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials up to September 1, 2023. The primary endpoints were operative mortality and incidence of postoperative stroke. Secondary endpoints encompassed cardiopulmonary bypass time, myocardial ischemic time, hypothermic circulatory arrest time, postoperative temporary neurological dysfunction, combination of stroke and temporary neurological dysfunction, as well as the need for reexploration for bleeding, renal replacement therapy, and tracheotomy. A random-effect model was utilized to calculate the pooled effect size. Results Eleven studies met our eligibility criteria, enrolling a total of 7204 patients (2760 underwent aortic cannulation and 4444 underwent axillary cannulation). The operative mortality and incidence of postoperative stroke did not show statistical differences between the two groups, with a pooled odds ratio of 1.07 (95% confidence interval: 0.73–1.55) and 1.17 (0.95–1.42), respectively. Similarly, none of the secondary endpoints exhibited significant statistical differences between the two groups. Conclusions Aortic cannulation can be a viable alternative to axillary artery cannulation for repair of acute aortic dissection type A, as both approaches present similar early clinical outcomes.

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Section: Study Characteristicsmentioning

confidence: 99%

Aortic versus axillary cannulation in acute type A aortic dissection repair: A meta-analysis

Yamashita,

Sicouri,

Dokollari

et al. 2024

Asian Cardiovasc Thorac Ann

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Central versus peripheral cannulation for acute type A aortic dissection: A meta-analysis of over 14,000 patients

Samadzadeh Tabrizi,

Sá,

Jacquemyn

et al. 2024

The American Journal of Surgery

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Direct aortic cannulation versus femoral arterial cannulation for early outcomes in acute type A aortic dissection: A study-level meta-analysis

Yamashita,

Sicouri,

Kjelstrom

et al. 2024

Perfusion

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Purpose To investigate the impact of direct aortic cannulation (DAC) versus femoral arterial cannulation (FAC) on clinical outcomes of surgery for acute type A aortic dissection. Methods PubMed/MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were searched until August 25, 2023, to conduct a meta-analysis. Primary endpoints of the study were operative mortality and postoperative stroke. Secondary endpoints were cardiopulmonary bypass time, myocardial ischemic time, hypothermic circulatory arrest time, temporary neurological dysfunction (TND), combined stroke and TND, re-exploration for bleeding, and need for renal replacement therapy. A random-effect model was used to estimate the pooled effect size, and a leave-one-out method was used for the primary endpoints for sensitivity analysis. Results 15 studies met our eligibility criteria, including a total of 7941 samples. Operative mortality was significantly lower in the DAC group with a pooled odds ratio (OR) of 0.72 [95% confidence interval (CI): 0.61–0.85)]. Incidence of postoperative stroke was also lower in the DAC group with a pooled OR of 0.79 (95% CI: 0.66–0.94). However, after excluding one study with the greatest weight, the difference became nonsignificant. DAC was also associated with a lower incidence of postoperative TND, and re-exploration for bleeding with a pooled OR of 0.52 (95% CI: 0.37–0.73), and 0.60 (95% CI: 0.47–0.77), respectively. Conclusions This meta-analysis showed that patients who underwent ATAAD repair with DAC had a lower incidence of operative mortality, postoperative stroke, TND, and re-exploration for bleeding compared to those who underwent FAC.

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Does arterial cannulation site for aortic dissection repair impact surgical outcomes?

Cited by 4 publications

References 22 publications

Aortic versus axillary cannulation in acute type A aortic dissection repair: A meta-analysis

Aortic versus axillary cannulation in acute type A aortic dissection repair: A meta-analysis

Central versus peripheral cannulation for acute type A aortic dissection: A meta-analysis of over 14,000 patients

Direct aortic cannulation versus femoral arterial cannulation for early outcomes in acute type A aortic dissection: A study-level meta-analysis

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