Related Experiment Video
Updated: Jun 21, 2026
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Double-arterial cannulation for aortic valve replacement with porcelain aorta
Ruggero De Paulis1, Daniele Maselli, Raffaele Scaffa
1Division of Cardiac Surgery, European Hospital, via Portuense, 700, 00149 Rome, Italy. depauli@tin.it
Summary
This study introduces a novel aortic valve replacement (AVR) technique for porcelain aorta patients, achieving zero operative mortality. The method ensures safe cerebral perfusion and avoids aortic cross-clamping, simplifying the procedure.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Devices
Background:
- Porcelain aorta presents significant challenges for aortic valve replacement (AVR) due to calcification and rigidity.
- Traditional AVR techniques may involve complex aortic manipulation, increasing risks in these patients.
Purpose of the Study:
- To describe and evaluate a novel AVR technique specifically designed for patients with porcelain aorta.
- To assess the safety, efficacy, and key procedural advantages of this new surgical approach.
Main Methods:
- Cardiopulmonary bypass (CPB) established via side-graft right axillary artery and direct femoral artery cannulation.
- Mild hypothermia (30°C) and controlled cerebral perfusion by selectively clamping epiaortic vessels.
- Aortic occlusion using a Foley balloon in the isthmus, enabling longitudinal aortotomy for valve replacement.
Main Results:
- Zero operative mortality observed in three treated patients (mean age 75 years).
- Mean CPB time was 73 minutes, with near-infra-red spectroscopy (NIRS) confirming maintained cerebral tissue oxygenation (>55%).
- Uneventful postoperative recovery, highlighting the technique's safety and effectiveness.
Conclusions:
- This novel AVR technique offers simultaneous cerebral and systemic perfusion via axillary and femoral artery cannulation.
- It avoids traditional aortic cross-clamping and allows greater flexibility in aortotomy placement, enhancing safety in porcelain aorta cases.
- The described method represents a promising advancement for managing complex AVR in high-risk patients.
