[Alternative arterial cannulation site in acute aortic dissections].

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Context:

• Acute aortic dissection is a life-threatening condition requiring emergent surgical intervention.
• Traditional arterial inflow sites (femoral, axillary) for extracorporeal circulation carry risks of complications.
• These complications include inadequate flow, retrograde dissection, and malperfusion syndrome.

Purpose:

• To evaluate the safety and efficacy of transventricular cannulation for establishing extracorporeal circulation in acute aortic dissection.
• To demonstrate the potential of transventricular cannulation in reducing periprocedural morbidity and mortality.

Summary:

• A study involving 107 patients with acute ascending aortic dissection compared femoral artery cannulation (91 patients) with transventricular cannulation (16 patients).
• The transventricular approach resulted in no neurological incidents or other complications related to extracorporeal circulation.
• One death occurred postoperatively due to multiorgan insufficiency, unrelated to the cannulation method.

Impact:

• Transventricular cannulation provides a simple, safe, and quick method for establishing extracorporeal circulation.
• This technique ensures sufficient antegrade physiological flow, minimizing malperfusion syndrome and neurological complications.
• It effectively avoids the negative effects associated with traditional femoral or axillary artery cannulation.