Direct innominate artery cannulation in surgery for annuloaortic ectasia.
BACKGROUND
The selection of the ideal cannulation site is still one of the major concerns in ascending aortic surgery. In the last decade, many surgeons have chosen to utilize antegrade cerebral perfusion in hypothermic circulatory arrest. In this study, we aimed to evaluate arterial cannulation techniques in patients who underwent root replacement for annuloaortic ectasia.


METHODS
Between 2005 and 2012, a total of 69 patients with a diagnosis of annuloaortic ectasia underwent aortic root replacement with femoral artery, axillary artery, and direct innominate artery cannulation (IAC). Patients demographic, operative, and postoperative data were collected prospectively and analyzed.


RESULTS
A total of 69 patients were investigated. Their ages varied from 13 to 78 (mean age was 54.25 ± 15.69) and 48 patients were male (69.5%). Mean aortic diameter was 5.65 ± 1.58 cm (min: 4.5 cm to max: 7.8 cm) by computerized tomography. The procedures included modified Bentall operation in 61 patients, and Cabrol operation in eight patients. In hospital, the mortality rate was 1.85%, and a 30-day mortality rate was 3.7% in the IAC group and 6.6% in patients who underwent femoral and axillary artery cannulation. Temporary cognitive dysfunction and stroke rate were similar between groups.


CONCLUSIONS
Innominate cannulation is associated with low morbidity and mortality in patients who underwent ascending aorta surgery.
Department of Cardiovascular Surgery, Acibadem University Aile Hospital, Istanbul, Turkey.
A Faruk
AF
Hokenek
Barbaros
B
Kinoglu
Mete
M
Gursoy
Gokce
G
Sirin
Fusun
F
Gulcan
D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D001366:Axillary Artery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000379:methods; D002404:Catheterization / Q000379:methods* / Q000401:mortality; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005263:Femoral Artery; D006324:Heart Arrest, Induced; D017052:Hospital Mortality; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods; D011446:Prospective Studies