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Related Experiment Videos

Ascending aorta cannulation in acute type A aortic dissection.

Yoshito Inoue1, Toshihiko Ueda, Shinichi Taguchi

  • 1Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi, Utsunomiya, Tochigi 321-0974, Japan. yosito_inoue@saimiya.com

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 27, 2007
PubMed
Summary

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Antegrade perfusion using the ascending aorta for acute type A aortic dissection is safe and effective. This method rapidly establishes cardiopulmonary bypass, reducing malperfusion and improving surgical outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Antegrade perfusion is crucial in acute type A aortic dissection to prevent complications during cardiopulmonary bypass.
  • Rapid establishment of antegrade perfusion is vital, especially in hemodynamically unstable patients.
  • The dissected ascending aorta presents a potential alternative site for arterial inflow.

Purpose of the Study:

  • To evaluate the efficacy and safety of using the ascending aorta as an arterial inflow source for antegrade perfusion.
  • To assess the impact of this technique on surgical outcomes in acute type A aortic dissection.
  • To determine if this method allows for prompt establishment of cardiopulmonary bypass.

Main Methods:

  • A retrospective review of 32 patients undergoing ascending aorta or hemiarch replacement for acute type A aortic dissection between 2002 and 2006.

Related Experiment Videos

  • Routine cannulation of the ascending aorta using Seldinger technique, with optional epiaortic ultrasonographic guidance.
  • Establishment of antegrade systemic perfusion via the ascending aorta.

    • Main Results:

    • Ascending aorta cannulation was safely achieved in all patients without malperfusion or thromboembolism.
    • Cardiopulmonary bypass was established within 30 minutes of skin incision.
    • Low in-hospital mortality (3.1%) and morbidity, including cerebral infarction (6.3%), with 90.6% of patients discharged in New York Heart Association class I.

    Conclusions:

    • Antegrade perfusion via the ascending aorta is a successful technique with low mortality and morbidity.
    • Ultrasound-guided Seldinger technique facilitates safe and rapid ascending aorta cannulation.
    • This approach offers a simple and safe option for prompt antegrade perfusion in acute type A aortic dissection.