title: Safety and efficacy of ascending aorta cannulation during repair of acute type A aortic dissection (PA29-04): "Presented at the 65th Annual Scientific Meeting of the Japanese Association for Thoracic Surgery".
abstract: OBJECTIVE
  Antegrade central perfusion for acute Stanford type A aortic dissection prevents malperfusion and retrograde cerebral embolism during cardiopulmonary bypass. Prompt establishment of antegrade perfusion via the ascending aorta may improve surgical results of type A dissections, especially in situations of hemodynamic instability. Thus, we evaluated the safety and efficacy of cannulation of the dissected ascending aorta in acute type A dissection.
  
  
  METHODS
  We reviewed the medical charts of patients undergoing repair of acute ascending aortic dissection (n = 52) from April 2010 to April 2013. Cannulation was accomplished in 29 patients via the ascending aorta (central) and in 23 patients via the femoral or axillary artery (peripheral). The ascending aorta was routinely cannulated using Seldinger technique under epiaortic ultrasound guidance. Comorbidities, mortality, complications, and durations of hospital stays were compared for the groups.
  
  
  RESULTS
  In all cases, routine cannulation of the ascending aorta was safely performed with no resultant malperfusion or thromboembolism. Mean operative duration, cardiopulmonary bypass time, intubation time, and intensive care unit stay were significantly shorter in the central group. Two patients (6.8 %) in the central group died compared with four patients (17.3 %) in the peripheral group (P = 0.005).
  
  
  CONCLUSIONS
  Antegrade central perfusion via the ascending aorta, a simple and safe technique that enables rapid establishment of antegrade systemic perfusion, was as safe as peripheral cannulation in patients with type A acute aortic dissection.
authors: Department of Cardiovascular Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan, mosumi@fukuoka-u.ac.jp.
authors: Masahiro
authors: M
authors: Osumi
authors: Hideichi
authors: H
authors: Wada
authors: Yuichi
authors: Y
authors: Morita
authors: Masayuki
authors: M
authors: Shimizu
authors: Yuta
authors: Y
authors: Sukehiro
authors: Mau
authors: M
authors: Amako
authors: Noritoshi
authors: N
authors: Minematsu
authors: Hitoshi
authors: H
authors: Matsumura
authors: Masaru
authors: M
authors: Nishimi
authors: Tadashi
authors: T
authors: Tashiro
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017130:Angioplasty / Q000379:methods*; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010477:Perfusion / Q000379:methods; D011183:Postoperative Complications; D013923:Thromboembolism / Q000517:prevention & control; D016896:Treatment Outcome; D014463:Ultrasonography