title: A safe and rapid direct true lumen cannulation for acute type A aortic dissection.
abstract: OBJECTIVE
  For the repair of acute type A aortic dissection (AADA), the optimal site of arterial cannulation remains controversial. We herein describe and investigate a technique for direct true lumen cannulation in patients with AADA.
  
  
  METHODS
  Between January 2011 and April 2012, 176 consecutive patients underwent emergency surgery for repair of AADA using the direct true lumen cannulation. Using this method, following temporary circulatory arrest, the dissected ascending aortic wall is incised transversely and the true lumen is identified. An aortic cannula is inserted into the true lumen directly, and the ascending aorta is snared tightly.
  
  
  RESULTS
  The manipulation was performed within 30 s in all patients. There were no technical problems with this method. The mean operative time, cardiopulmonary bypass time, cross-clamp time, and the circulatory arrest time were 241 ± 79, 158 ± 85, 123 ± 97 and 58 ± 39 min, respectively. There were no permanent neurological disorders following surgery. Seven patients (4.0 %) experienced temporary neurological disorders. Twenty-four patients (14 %) died in the hospital from several complications unrelated to technical problems of direct true lumen cannulation.
  
  
  CONCLUSIONS
  Antegrade perfusion can be established safely and easily using the direct true lumen cannulation, which may be a promising standard arterial cannulation technique for the repair of AADA.
authors: Department of Cardiovascular Surgery, Chibanishi General Hospital, 107-1 Kanegasaku, Matsudo 270-2251, Japan. kintaro@ruby.ocn.ne.jp
authors: Taro
authors: T
authors: Kanamori
authors: Tetsuya
authors: T
authors: Ichihara
authors: Hidehito
authors: H
authors: Sakaguchi
authors: Takehiko
authors: T
authors: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies