title: Direct and transapical central cannulation for acute type a aortic dissection.
abstract: OBJECTIVE
  The choice of cannulation site for the treatment of acute Stanford type A aortic dissection is much debated. We believe that central cannulation is quick to perform, easy to use, and safe to manage acute type A aortic dissection.
  
  
  METHODS
  We retrospectively investigated 26 cases of acute aortic dissection performed using two different central cannulation methods between April 2011 and March 2012. Direct ascending aortic cannulation was performed using the Seldinger technique in 20 patients, and transapical ascending aortic cannulation was performed in six patients in whom puncture was difficult.
  
  
  RESULTS
  Patients were 21-86 years old (mean age, 67 years). The surgical techniques used to treat aortic dissection were hemiarch repair in 21 patients and total arch replacement in 5 patients. The mean length of surgery was 393 min. One death (3.8%) was attributed to intestinal ischemia.
  
  
  CONCLUSIONS
  During surgery for acute aortic dissection, central cannulation using either transapical or direct puncture can be performed quickly and safely, and satisfactory short-term outcomes can be obtained. Because acute aortic dissection can present with various conditions, there is no single perfect surgical or cannulation method; therefore, the choice of surgical procedure should be individualized for each patient.
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka University, Faculty of Medicine, Fukuoka, Fukuoka, Japan.
authors.forename: Hideichi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka University, Faculty of Medicine, Fukuoka, Fukuoka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsumura
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka University, Faculty of Medicine, Fukuoka, Fukuoka, Japan.
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Minematsu
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka University, Faculty of Medicine, Fukuoka, Fukuoka, Japan.
authors.forename: Mau
authors.initials: M
authors.lastname: Amako
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka University, Faculty of Medicine, Fukuoka, Fukuoka, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Nishimi
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka University, Faculty of Medicine, Fukuoka, Fukuoka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tashiro
keywords: aortic dissection; ascending cannulation; central cannulation