Combined femoral and axillary perfusion strategy for Stanford type a aortic dissection repair
- PDF / 496,269 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 90 Downloads / 183 Views
(2020) 15:326
RESEARCH ARTICLE
Open Access
Combined femoral and axillary perfusion strategy for Stanford type a aortic dissection repair Ling-chen Huang†, Qi-chen Xu†, Dao-zhong Chen, Xiao-fu Dai and Liang-wan Chen*
Abstract Background: The optimal cannulation strategy in surgery for Stanford type A aortic dissection is critical to patient survival but remains controversial. Different cannulation strategies have their own advantages and drawbacks during cardiopulmonary bypass. Our centre used a combined femoral and axillary perfusion strategy for the surgical treatment of type A aortic dissection. The purpose of this study was to review and clarify the clinical outcome of femoral artery cannulation combined with axillary artery cannulation for the treatment of Stanford type A aortic dissection. Methods: We performed a retrospective study that included 327 patients who were surgically treated for type A aortic dissection in our institution from January 2017 to June 2019. Femoral and axillary artery cannulation was used to establish cardiopulmonary bypass in patients with type A aortic dissection. The demographic data, surgical data, and clinical results of the patients were calculated. Results: Femoral artery combined with axillary artery cannulation was technically successful in 327 patients. The cardiopulmonary bypass time was 141.60 ± 34.89 min, and the selective antegrade cerebral perfusion time was 14.94 ± 2.76 min. The early mortality rate was 3.06%. The incidence of permanent neurologic dysfunction was 0.92%. Sixteen patients had postoperative renal insufficiency, and five patients had liver failure. Conclusion: Femoral artery combined with axillary artery cannulation for type A aortic dissection can significantly improve the prognosis of patients, especially in terms of cerebral protection, and can reduce the occurrence of adverse malperfusion syndrome and neurological complications. Keywords: Aortic dissection, Artery cannulation, Malperfusion
Introduction Stanford type A aortic dissection (TAAD) is a surgical emergency with high rates of surgical complications and mortality [1, 2]. The optimal cannulation strategy in surgery for TAAD is critical to patient survival but remains controversial [3–6]. Because the lesion mainly involves the ascending aorta and the aortic arch, the ascending * Correspondence: [email protected] † Ling-chen Huang and Qi-chen Xu contributed equally to this work. Ling-chen Huang and Qi-chen Xu are first author Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, People’s Republic of China
aorta is often not suitable for cannulation to set up the extracorporeal circulation. Various cannulation techniques to establish cardiopulmonary bypass (CPB) for the emergency treatment of TAAD have been reported [7–9]. The femoral artery and the axillary artery have become common alternative cannulation sites. Each of these cannulation sites has its own advantages and disadvantages, and the selection strategy is often affected by the range of lesio
Data Loading...
