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In thoracic aortic surgery, is innominate artery cannulation a safe and effective alternative to axillary artery

Amer Harky1, Ciaran Grafton-Clarke2, Max Hadlett3

  • 1Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.

Interactive Cardiovascular and Thoracic Surgery
|June 11, 2019
PubMed

Insights

Innominate artery cannulation is a safe and effective alternative to axillary artery cannulation for thoracic aortic surgery. Both methods show similar mortality rates and neuroprotection, with innominate artery cannulation potentially offering a slight stroke reduction.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Aortic Surgery
  • Surgical Cannulation Techniques

Background:

  • Thoracic aortic surgery necessitates effective cannulation strategies for patient outcomes.
  • Axillary artery cannulation is a common approach, but alternatives are explored for improved safety and efficacy.

Purpose of the Study:

  • To compare the postoperative outcomes of innominate artery cannulation versus axillary artery cannulation in patients undergoing thoracic aortic surgery.
  • To determine if innominate artery cannulation offers superior or non-inferior results compared to axillary artery cannulation.

Main Methods:

  • A systematic review and best-evidence topic synthesis was conducted.
  • Five studies, including a randomized trial and observational cohorts, comprising 1338 patients (616 innominate, 722 axillary) were analyzed.

Main Results:

  • No statistically significant difference in 30-day or in-hospital mortality was observed between innominate and axillary artery cannulation (P > 0.05).
  • Stroke incidence was slightly lower with innominate artery cannulation in three of four studies, though not statistically significant (P > 0.05).

Conclusions:

  • Innominate artery cannulation is non-inferior to axillary artery cannulation for thoracic aortic surgery.
  • Both techniques offer comparable neuroprotection and are not associated with increased mortality, making innominate artery cannulation a viable alternative.

Keywords:
Aortic surgeryAxillary arteryCannulationInnominate artery

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