Open Seldinger-Guided Femoral Artery Cannulation Technique for Thoracic Aortic Surgery

Tsiouris, Athanasios; Elkinany, Sherif; Ziganshin, Bulat A.; Elefteriades, John A.

doi:10.1016/j.athoracsur.2015.12.032

Cited by 40 publications

(38 citation statements)

References 15 publications

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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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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 cannulation has been selected in most institutes based on previous reports of circumferential acute type A aortic dissection. Although femoral cannulation is considered easy and advantageous in hemodynamically unstable patients, embolic complications caused by atheromatous emboli are possible.4 Severe atherosclerosis in the distal arch, thoracoabdominal aorta, or iliofemoral system on preoperative computed tomography may be a reason to avoid femoral cannulation [9].…”

Section: Discussionmentioning

confidence: 99%

Circumferential Acute Type an Aortic Dissection with Intimo-Intimal Intussusception: The Efficacy of Central Aortic Cannulation

Yamashita¹,

Tabayashi²,

Abe³

et al. 2017

J Clin Case Rep

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An 80-year-old woman suffered from acute chest pain and then exhibited cardiogenic shock. Transthoracic echocardiography revealed severe aortic regurgitation due to the intussusception of the intima. Computed tomography also showed the intussusception of the intima into the left ventricular outflow tract over the aortic valve and dissection involving the aortic root, aortic arch, and descending thoracic aorta. During surgery, echocardiography-guided central aortic cannulation was performed for the prompt establishment of cardiopulmonary bypass. The complete intimal tear was circumferentially located in the middle level of the ascending aorta. The proximal flap was inverted into the left ventricle, and the distal flap had been pushed into the aortic arch. Graft replacement of the ascending aorta was performed successfully, and the patient had an uneventful postoperative course.

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“…The femoral artery has been the cannulation site of choice for a number of years [5], and still is in many institutions, including centers that are renowned for aortic surgery [34]. Some centers have described their extensive experience with femoral cannulation and shown good results [23].…”

Section: Cannulation Strategiesmentioning

confidence: 99%

“…When limited exposure is thought to be enough for arterial cannulation, oblique incision may be selected [35]. When cannulating, the open Seldinger technique may be beneficial because it is quick, requires minimal dissection and manipulation of the femoral artery, and allows maintenance of limb perfusion [34]. Exposing the femoral arteries is relatively easy.…”

Section: Cannulation Strategiesmentioning

confidence: 99%

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The cannulation strategy in surgery for acute type A dissection

Abe

Usui

2016

Gen Thorac Cardiovasc Surg

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The rates of mortality and morbidity remain high in surgery for acute type A dissection. There is controversy regarding the best cannulation strategy for achieving good clinical results. Each cannulation technique has different anatomical characteristics and a different flow pattern inside the aorta during cardiopulmonary bypass. Some adverse, clinically important outcomes may be related to events at this time. Femoral artery cannulation, axillary artery cannulation, and central aortic cannulation are the three major cannulation strategies that are adopted in many centers in the world. Accumulating results from comparative studies between right axillary artery cannulation and femoral artery cannulation show that right axillary artery cannulation is associated with better clinical outcomes. However, all of the studies have been retrospective, and few studies have compared the results of other combinations of cannulation strategies. Observational studies using newer monitoring techniques clearly show that no perfusion strategy is perfect or free from complications. In summary, the evidence is insufficient to make a strong recommendation regarding cannulation strategies. Based on the fairly consistent results of retrospective studies, more surgeons are tending to switch from a retrograde perfusion strategy to adopt an antegrade perfusion strategy. Regardless of the routine cannulation strategy that is adopted, careful monitoring and a swift response to adverse events are necessary. The further accumulation of evidence is warranted.

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Open Seldinger-Guided Femoral Artery Cannulation Technique for Thoracic Aortic Surgery

Cited by 40 publications

References 15 publications

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

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

Circumferential Acute Type an Aortic Dissection with Intimo-Intimal Intussusception: The Efficacy of Central Aortic Cannulation

The cannulation strategy in surgery for acute type A dissection

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