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Proximal aortic arch cannulation for proximal ascending aortic aneurysms
Bilgin Emrecan1, Firat Durna1, Serkan Girgin1
1Department of Cardiovascular Surgery, Pamukkale University, Denizli, Turkey.
Insights
Aortic arch cannulation is a safe and simple technique for ascending aorta replacement, showing no mortality or morbidity in a study of 27 patients. This method offers a low-morbidity option for treating ascending aortic aneurysms.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Ascending aorta replacement often requires specific arterial inflow sites.
- Common sites include the ascending aorta, femoral, and subclavian arteries.
- Aortic arch cannulation is less common despite reported use.
Purpose of the Study:
- To evaluate the treatment outcomes of aortic arch cannulation for ascending aorta replacement.
- To assess the safety and efficacy of this technique in patients with ascending aortic aneurysms.
Main Methods:
- Aortic arch cannulation distal to the innominate artery was performed in 27 patients.
- Procedures were conducted between April 2010 and March 2013.
- Patients underwent ascending aorta replacement, with some receiving the Bentall procedure.
Main Results:
- No mortality or cannulation-related morbidity was observed.
- 23 patients had supracoronary ascending aorta replacement.
- 4 patients underwent the button modification of the Bentall procedure.
Conclusions:
- Aortic arch cannulation distal to the innominate artery is a safe and simple technique.
- It is a viable option for aneurysms limited to the ascending aorta.
- The technique demonstrates low morbidity and warrants consideration.
Introduction:
Different arterial inflow sites have been reported to date for particularly challenging cardiac operations. The ascending aorta, femoral artery, and subclavian artery are the most commonly used sites. Although its use has been reported, the aortic arch has not gained popularity in the performance of cannulation. According to a search performed in the PubMed database, aortic arch cannulation for ascending aorta replacement has not been examined in a separate study before. In the present study, we report the treatment outcomes of patients with ascending aortic aneurysms in whom the aortic arch was cannulated for arterial inflow.
Material And Methods:
Twenty-seven patients with aneurysmal dilatation of the ascending aorta underwent ascending aorta replacement from April 2010 to March 2013. The mean age of the patients was 64 years. All operations were carried out by cannulating the aortic arch distally from the origin of the innominate artery.
Results:
There was no mortality or cannulation-related morbidity. In 23 patients, only the supracoronary ascending aorta was replaced, whereas in 4 patients, the button modification of the Bentall procedure was performed to replace the root and the ascending aorta.
Conclusions:
The technique of aortic arch cannulation distal to the origin of the innominate artery is worthy of consideration in the treatment of aneurysms limited to the ascending aorta due to its safety, simplicity, and low morbidity.
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