A safe and rapid direct true lumen cannulation for acute type A aortic dissection

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• The optimal arterial cannulation site for acute type A aortic dissection (AADA) repair is debated.
• Direct true lumen cannulation offers a potential alternative to traditional methods.

Purpose of the Study:

• To describe and evaluate a technique for direct true lumen cannulation in AADA repair.
• To assess the safety and efficacy of this novel cannulation method.

Main Methods:

• 176 patients with AADA underwent emergency repair using direct true lumen cannulation between January 2011 and April 2012.
• The technique involves incising the dissected ascending aorta, identifying the true lumen, and inserting an aortic cannula.
• The ascending aorta is then tightly snared around the cannula.

Main Results:

• The cannulation procedure was consistently performed within 30 seconds without technical issues.
• Mean operative times were: total 241 min, cardiopulmonary bypass 158 min, cross-clamp 123 min, and circulatory arrest 58 min.
• No permanent neurological deficits occurred; 4.0% experienced temporary neurological disorders. In-hospital mortality was 14%, unrelated to cannulation technique.

Conclusions:

• Direct true lumen cannulation allows for safe and easy establishment of antegrade perfusion.
• This technique shows promise as a standard arterial cannulation method for AADA repair.