Treatment of malperfusion during surgery for type A aortic dissection.
During surgery for acute type A aortic dissection, malperfusion may occur during cardiopulmonary bypass. Retrograde perfusion trough femoral cannulation is considered a predisposing factor. However, this may occur even with antegrade perfusion, because of the presence of multiple flaps or compression of the true lumen by the false lumen. In this particular setting, the aim is to reach a perfusion of the true lumen of the dissected aorta. A technique of epicardial ultrasound-guided direct cannulation of the dissected aorta's true lumen by a Seldinger technique may help in those cases. We describe the technique with particular interest to the epicardial ultrasound control and the type of arterial cannula to be inserted by the Seldinger technique.
Lentini
Salvatore
S
Cardiac Surgery Unit and Perfusion Service, Policlinico G. Martino, University of Messina, Messina, Italy. salvolentini@alice.it
Savasta
Marcello
M
Ciuffreda
Francesco
F
La Monaca
Marco
M
Gaeta
Roberto
R
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D014463:Ultrasonography / Q000379:methods
Ann Thorac Surg. 2007 Mar;83(3):1219-24
17307506
J Thorac Cardiovasc Surg. 2006 Aug;132(2):369-72
16872964
J Thorac Cardiovasc Surg. 2007 Jul;134(1):244-5
17599522
J Cardiothorac Vasc Anesth. 2006 Feb;20(1):3-7
16458205
Ann Thorac Surg. 2003 Jan;75(1):266-8
12537227
Ann Thorac Surg. 1994 Apr;57(4):820-4; discussion 825
8166525
J Card Surg. 1996 Sep-Oct;11(5):355-8
8969381
J Cardiothorac Vasc Anesth. 2005 Aug;19(4):446-52
16085248
Interact Cardiovasc Thorac Surg. 2008 Feb;7(1):133-4
17951272
J Cardiothorac Vasc Anesth. 2007 Feb;21(1):81-4
17289485
Interact Cardiovasc Thorac Surg. 2008 Feb;7(1):134-5
18234777
Ann Thorac Surg. 1993 Aug;56(2):358-61
8347022
Ann Thorac Surg. 2008 May;85(5):1619-24
18442550
Ann Thorac Surg. 2003 Dec;76(6):2115-7
14667666
Ann Thorac Surg. 2004 Oct;78(4):1285-9; discussion 1285-9
15464486
J Thorac Cardiovasc Surg. 2005 May;129(5):1190-1
15867808
Ann Thorac Surg. 2003 Sep;76(3):948
14528892
J Thorac Cardiovasc Surg. 1999 Aug;118(2):324-9
10425006
J Thorac Cardiovasc Surg. 2005 Feb;129(2):277-85
15678036
Ann Thorac Surg. 2008 Oct;86(4):1400; author reply 1400
18805217