title: Treatment of malperfusion during surgery for type A aortic dissection.
abstract: 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.
authors.affiliation: Cardiac Surgery Unit and Perfusion Service, Policlinico G. Martino, University of Messina, Messina, Italy. salvolentini@alice.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lentini
authors.forename: Marcello
authors.initials: M
authors.lastname: Savasta
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciuffreda
authors.forename: Marco
authors.initials: M
authors.lastname: La Monaca
authors.forename: Roberto
authors.initials: R
authors.lastname: Gaeta
mesh_terms: 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
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