Related Experiment Video
Updated: May 24, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
[Ascending aorta cannulation in stanford type a acute aortic dissection]
Tatsuya Seki1, Ryushi Maruyama, Yousuke Inoue
1Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan.
Insights
Ascending aorta cannulation offers a safe and effective method for establishing cardiopulmonary bypass in acute aortic dissection type A. This technique avoids complications, ensuring antegrade flow through the true lumen.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Acute aortic dissection type A (AAD) requires rapid and safe cardiopulmonary bypass.
- Cannulation strategies include femoral artery, axillary artery, ascending aorta, and left ventricular apex.
- Maintaining antegrade flow through the true lumen is critical for type A AAD management.
Purpose of the Study:
- To evaluate the safety and efficacy of ascending aorta cannulation for cardiopulmonary bypass in type A AAD.
- To compare ascending aorta cannulation with traditional femoral artery cannulation.
Main Methods:
- Ascending aorta cannulation using the Seldinger technique was performed in 8 patients.
- Real-time imaging with epiaortic color Doppler and transesophageal echocardiography guided cannulation.
- Data were compared with a control group undergoing femoral artery cannulation.
Main Results:
- Ascending aorta cannulation was successfully and easily performed.
- No cerebral events or hypoperfusion-related complications were observed in the ascending aorta cannulation group.
- Femoral artery cannulation served as the control group for comparison.
Conclusions:
- Ascending aorta cannulation is a safe and effective cannulation strategy for cardiopulmonary bypass in type A AAD.
- This method facilitates antegrade flow and avoids major complications.
- The Seldinger technique, guided by advanced echocardiography, ensures procedural success.
Abstract:
Establishment of cardiopulmonary bypass for Stanford type A acute aortic dissection( type A AAD) should be quick and safe. The femoral artery, axillary artery, ascending aorta, and left ventricular apex are potential access points for cannulation. The most important reason for establishing cardiopulmonary bypass for type A AAD is to allow antegrade blood flow through the true lumen. Starting in 2007, Jakob et al, and Inoue et al. applied the technique of ascending aortic cannulation for type A AAD. From 2008, we applied this method of ascending aorta cannulation in 8 patients and compared preoperative, operative, and postoperative data with a control group, or the femoral artery cannulation group. Ascending aorta cannulation was done safely and easily with the use of the Seldinger technique under epiaortic color Doppler echography and transesophageal echography. No cerebral events or hypoperfusion-based complications occurred in the group of ascending aorta cannulation. Given that no cases of complication occurred using this method, it could be considered as an effective choice of cannulation for cardiopulmonary bypass.
