Femoral artery cannulation for thoracic aortic surgery: Safe under transesophageal echocardiographic control

Ayyash, Bassem; Tranquilli, Maryann; Elefteriades, John A.

doi:10.1016/j.jtcvs.2011.04.005

Cited by 54 publications

(40 citation statements)

References 23 publications

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“…In fact, the femoral artery was commonly soft and pliable, like that of a child or young adult, even without the fatty streaks that are known to begin at an early age in American males [3]. …”

Section: Clinical Observations and Studiesmentioning

confidence: 99%

Silver Lining in the Dark Cloud of Aneurysm Disease

Chau

Bender²,

Elefteriades³

2014

Cardiology

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An ascending aortic aneurysm is a common and very much unwelcome diagnosis that has never been associated with anything positive. We believe, however, that there actually is a silver lining to this disease: aortic root and ascending aortic aneurysms actually protect against atherosclerosis. We have found that patients with ascending aneurysms have both decreased arterial calcification and carotid intima-media thickness, late and early indicators of atherosclerosis, respectively. In addition to these clinical data, we also found data regarding molecular mechanisms, genetic studies, and pharmacologic evidence that corroborate our clinical findings, in particular, evidence regarding matrix metalloproteinases and transforming growth factor-β pathways. In this article, we lay out the evidence that has been accruing for the protective effect of ascending aneurysms against atherosclerosis.

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Section: Clinical Observations and Studiesmentioning

confidence: 99%

Silver Lining in the Dark Cloud of Aneurysm Disease

Chau

Bender²,

Elefteriades³

2014

Cardiology

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“…On the contrary, ascending thoracic aortic aneurysms (TAAs) appear to be caused by genetic mutations [7,8,9,10,11] and have a negative correlation with atherosclerosis [12]. During aortic replacement surgeries at our institution, we observed that the arteries of patients with ascending TAAs were often very pliable, in particular the femoral arteries that were cannulated for cardiopulmonary bypass [13]. This observation was followed by a study analyzing total body arterial calcium score in patients with ascending TAA or Type A dissection compared to controls.…”

Section: Introductionmentioning

confidence: 99%

Carotid Intima-Media Thickness Provides Evidence that Ascending Aortic Aneurysm Protects against Systemic Atherosclerosis

et al. 2012

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Previous evaluation of total aortic calcium score suggests that mutations promoting ascending aortic aneurysm development may protect against atherosclerosis. However, calcium score is a late indicator of atherosclerosis. We evaluated carotid intima-media thickness (IMT), an earlier marker, to assess the degree of atherosclerosis in ascending aortic aneurysm patients compared to controls. Images of right and left common carotid arteries were obtained in 52 patients with ascending aortic aneurysms and 29 controls using a Sonosite MicroMaxx ultrasound. IMT was measured with Sonosite Sonocalc IMT software, a computer-based algorithm with manual override. Six IMT measurements were obtained for each patient (right and left proximal, mid and distal common carotid artery) by a single observer and averaged. A multiple linear regression analysis was applied to test for an association between aneurysm and IMT. Patients with ascending aortic aneurysms had 0.131-mm lower carotid IMT values than controls (p = 0.0002), independent of risk factors for atherosclerosis (age, BMI, gender, family history, smoking, dyslipidemia, race, diabetes and hypertension). The average IMT was 0.50 ± 0.13 mm for individuals with aneurysm and 0.60 ± 0.11 mm for controls. Age increased the IMT by 0.005 mm per year (p = 0.0003). BMI, male gender, positive family history, dyslipidemia, diabetes and hypertension also increased the IMT, but did not reach statistical significance. This investigation provides further evidence that ascending aortic aneurysm provides protection against the development of atherosclerosis, supporting the hypothesis that proaneurysmal genetic mutations may also be antiatherogenic.

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“…Femoral cannulation represents our standard technique and provides simplicity and effectiveness. 19,20 We reserve an axillary approach for cases with a ''dirty'' aorta on preoperative computed tomography or intraoperative transesophageal echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Aortic valve disease with ascending aortic aneurysm: Impact of concomitant root-sparing (supracoronary) aortic replacement in nonsyndromic patients

Peterß

Charilaou

Dumfarth

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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Femoral artery cannulation for thoracic aortic surgery: Safe under transesophageal echocardiographic control

Abstract: This large experience in the TEE era strongly supports femoral cannulation for aortic surgery, with good survival, low stroke rate, minimal perfusion-related rupture or dissection, and minimal limb ischemia. If intraoperative TEE shows mobile atheroma, axillary cannulation is preferred.

Cited by 54 publications

References 23 publications

Silver Lining in the Dark Cloud of Aneurysm Disease

Silver Lining in the Dark Cloud of Aneurysm Disease

Carotid Intima-Media Thickness Provides Evidence that Ascending Aortic Aneurysm Protects against Systemic Atherosclerosis

Aortic valve disease with ascending aortic aneurysm: Impact of concomitant root-sparing (supracoronary) aortic replacement in nonsyndromic patients

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