Document Detail

Central cannulation is safe in acute aortic dissection repair.
MedLine Citation:
PMID:  17258578     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The site of cannulation for the repair of ascending aortic dissection remains controversial. It is not clear whether cannulation of the dissected vessel is safe or even preferred. We hypothesized that cannulation of the dissected aorta could be done safely with acceptable complication and mortality rates in this high-risk population. METHODS: The charts of repairs of acute ascending aortic dissections (n = 70) from 1996 to 2005 were reviewed. Cannulation was accomplished in 24 patients via the dissected aorta (central) and in 46 patients through cannulation of the femoral or axillary artery (peripheral). All were converted to sidearm cannulation of the graft for reperfusion. Groups were compared on the basis of comorbidities in addition to mortality, complications, hospital stays and final disposition. RESULTS: The groups were comparable on the basis of age and preoperative comorbidities. Similarly, there were no differences in bypass time, crossclamp time, or hypothermic circulatory arrest time between groups. Hospital mortality and postoperative complications, including stroke, were similar between groups, but the peripheral group experienced more cardiac events (peripheral 15% vs central 0%; P < .05) and higher mortality than the central group (peripheral 19.5% vs central 4.2%; P < .05). CONCLUSIONS: Direct cannulation of the dissected aorta was safe compared with peripheral cannulation in these patients. Inasmuch as these data demonstrate that cannulation of the dissected ascending aorta is safe, this technique can be used to tailor the cannulation approach to specific anatomic and patient characteristics that might optimize postoperative outcomes in this disease entity.
T Brett Reece; Curtis G Tribble; Robert L Smith; R Ramesh Singh; Brendon M Stiles; Benjamin B Peeler; John A Kern; Irving L Kron
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-12-29
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  133     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-02-23     Revised Date:  2007-09-28    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  428-34     Citation Subset:  AIM; IM    
University of Virginia, Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Charlottesville, Va, USA.
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MeSH Terms
Acute Disease
Aneurysm, Dissecting / mortality,  radiography,  surgery*
Aortic Aneurysm, Thoracic / mortality,  radiography,  surgery*
Axillary Artery
Blood Vessel Prosthesis Implantation / methods*
Catheterization, Central Venous / methods*
Catheterization, Peripheral / methods
Cohort Studies
Femoral Artery
Follow-Up Studies
Middle Aged
Retrospective Studies
Risk Assessment
Survival Rate
Treatment Outcome
Comment In:
J Thorac Cardiovasc Surg. 2007 Aug;134(2):547-8; author reply 548   [PMID:  17662824 ]
J Thorac Cardiovasc Surg. 2007 Aug;134(2):545; author reply 545   [PMID:  17662820 ]
J Thorac Cardiovasc Surg. 2007 Aug;134(2):545-7; author reply 547   [PMID:  17662821 ]

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