Direct and transapical central cannulation for acute type a aortic dissection.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• The optimal cannulation strategy for acute Stanford type A aortic dissection remains a subject of debate.
• Central cannulation is proposed as a rapid, straightforward, and safe method for managing this critical condition.

Purpose of the Study:

• To evaluate the safety and efficacy of central cannulation techniques in patients undergoing surgery for acute Stanford type A aortic dissection.
• To compare outcomes between direct ascending aortic cannulation and transapical ascending aortic cannulation.

Main Methods:

• A retrospective analysis of 26 patients with acute aortic dissection treated between April 2011 and March 2012.
• Two central cannulation methods were employed: direct ascending aortic cannulation (Seldinger technique) in 20 patients and transapical ascending aortic cannulation in 6 patients.

Main Results:

• The study included patients aged 21-86 years (mean 67).
• Surgical procedures involved hemiarch repair (21 patients) and total arch replacement (5 patients).
• The mean operative time was 393 minutes, with one death (3.8%) due to intestinal ischemia.

Conclusions:

• Central cannulation, via direct or transapical puncture, is a fast and safe method for acute aortic dissection surgery, achieving satisfactory short-term outcomes.
• Individualized treatment selection is crucial due to the varied presentations of acute aortic dissection.