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Femoral or axillary artery as a cannulation site in the acute aortic dissection type A surgery: is there still a doubt?
Journal of Cardiothoracic Surgery volume 8, Article number: O27 (2013)
Background
Anterograde perfusion is widely addopted strategy in aortic dissection type A treatement. Physiological blood flow direction reduces malperfusion complications during CPB and allows anterograde cerebral perfusion during circulatory arrest. In spite of these facts, femoral artery is still used as a cannulation site by surgeons worldwide. Primary end point was to analize the mortality in the two groups of patients (anterograde vs retrograde perfusion during CPB). Secondary end point was to compare frequency of postoperative complications, length of stay in ICU and in hospital.
Methods
We performed a retrospective sudy that included 99 patients which were surgically treated for acute aortic dissection type A in Clinical Center of Serbia from 01.01.2010 to 31.01.2013. Patients were divided into two groups according to the cannulation site for CPB (anterograde vs retrograde CPB). We analized comorbidities, operative parameters, postoperative complications and intrahospital mortality between the two groups of patients.
Results
In the anterograde perfusion group longer pain to admission and admission to OR period has been observed (p<0,05). Patients in the anterograde group had statistically significant less neurological, renal and respiratory postoperative complications (p<0,05). However there was no statisticaly significant difference between the two groups regarding intrahospital mortality (p<0,05).
Conclusion
In spite of lower complication rate in the anterograde perfusion group, there is stll not enough evidence of its superiority in every dissection case. The cannulation site in an aortic dissection type A surgery remains a surgeon's preference and should be carefully chosen on a case-by-case basis.
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Matkovic, M., Putnik, S., Cubrilo, M. et al. Femoral or axillary artery as a cannulation site in the acute aortic dissection type A surgery: is there still a doubt?. J Cardiothorac Surg 8, O27 (2013). https://doi.org/10.1186/1749-8090-8-S1-O27
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Keywords
- Postoperative Complication
- Cerebral Perfusion
- Lower Complication Rate
- Circulatory Arrest
- Axillary Artery
