Samurai cannulation (direct true-lumen cannulation) for acute Stanford Type A aortic dissection

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Acute Stanford Type A aortic dissection requires urgent surgical intervention.
• Cardiopulmonary bypass is essential for aortic repair, with cannulation strategy impacting outcomes.
• Evaluating novel cannulation techniques is crucial for improving patient safety and results.

Purpose of the Study:

• To investigate the early outcomes of surgical aortic repair for acute Stanford Type A aortic dissection.
• To compare the safety and efficacy of Samurai cannulation (direct true-lumen cannulation) versus other cannulation methods.

Main Methods:

• Retrospective review of inpatient and outpatient records for 100 patients undergoing surgery for acute Type A aortic dissection.
• Comparison of outcomes between patients who underwent Samurai cannulation (Group S, n=61) and those who underwent other cannulation options (Group O, n=39).

Main Results:

• Samurai cannulation achieved successful true-lumen cannulation in all patients, with no cannulation-related complications.
• 30-day mortality was 5% in Group S vs. 8% in Group O; in-hospital mortality was 7% vs. 15%, respectively.
• Stroke rates and long-term outcomes (survival, freedom from aorta-related death/events) were not significantly different between the groups.

Conclusions:

• Samurai cannulation is an easy, safe, and reasonable option for cardiopulmonary bypass in acute Stanford Type A aortic dissection surgery.
• The technique demonstrated favorable early outcomes with acceptable mortality and stroke rates.
• No cannulation-related complications were observed with Samurai cannulation in this series.