Outcome after aortic, axillary, or femoral cannulation for acute type A aortic dissection.
J Thorac Cardiovasc Surg
; 158(1): 27-34.e9, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31248512
ABSTRACT
OBJECTIVE:
The optimal method for arterial cannulation in acute aortic dissection type A (ADA) remains controversial. The aim of this study was to compare central ascending aortic, axillary, and femoral cannulation in patients who underwent surgery for acute ADA.METHODS:
Between 2006 and 2017, 584 patients were operated on for acute ADA. Of those, 355 (61%) underwent ascending aortic, 101 (17%) right axillary, and 128 (22%) femoral cannulation for arterial inflow. Clinical features and outcomes were compared after inverse probability weighting.RESULTS:
After inverse probability weighting there were no statistical differences in preoperative characteristics. Operative details differed significantly among the 3 groups hemiarch replacement was performed more often in the central aortic and the femoral group (P < .001), whereas total arch replacement was performed more often in the axillary group (P < .001). Cardiopulmonary bypass (P = .022) and aortic cross-clamp (P = .021) times were shortest in the aortic cannulation group and longest in the femoral cannulation group. Postoperative morbidities were similar; procedure-related stroke (P = .783) and the need for renal replacement therapy (P = .446). In-hospital mortality (P = .680) and long-term survival were similar (log rank, P = .704). Multilevel multivariate mixed effect logistic regression showed that the cannulation strategy was not associated with in-hospital mortality.CONCLUSIONS:
Central ascending aortic cannulation in patients with ADA can be used as safely as axillary or femoral cannulation, providing another option for quick and easy establishment of cardiopulmonary bypass.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Aneurisma Aórtico
/
Cateterismo Venoso Central
/
Dissecção Aórtica
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Alemanha