Central arterial cannulation and the arch first method for aortic arch aneurysm repair.
BACKGROUND
We investigated whether the axillary artery or ascending aorta cannulation combined with the arch first method decreases the risk of stroke during total arch replacement.


METHODS
From January 2002 to January 2006, 35 total arch replacements were performed with the arch first method and central arterial cannulation. The mean age was 66+/-10 years. The cannulation sites were the axillary artery in 19 and the ascending aorta in 16. The arch first method (a short period of deep hypothermic circulatory arrest with retrograde cerebral perfusion and then subsequent antegrade cerebral perfusion) was used in all patients.


RESULTS
The mean retrograde cerebral perfusion time was 29+/-7 min. The incidence of the permanent neurological dysfunction related to the surgical procedures was 2.9% (1/35). Hospital mortality was 5.7% of patients (2/35). There was no difference in the operative outcome between the 2 arterial inflow sites.


CONCLUSIONS
At the time of total arch replacement, the use of central arterial cannulation and the arch first method are effective methods for preventing permanent brain injury. Cannulation of the ascending aortic using Dispersion cannula perfusing toward the aortic valve is considered to be a safe and favorable method for central arterial cannulation.
Morishige
Noritsugu
N
Department of Cardiovascular Surgery, School of Medicine, Fukuoka University, Fukuoka, Japan.
Hayashida
Yoshio
Y
Ito
Nobuhisa
N
Takeuchi
Kazuma
K
Akasu
Koji
K
Iwahashi
Hidehiko
H
Tashiro
Tadashi
T
D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D002560:Cerebrovascular Circulation; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*