Echo-guided seldinger technique facilitates ascending aorta cannulation in type A aortic dissection.

Area of Science:

• Cardiovascular Surgery
• Vascular Access
• Aortic Dissection

Background:

• The ascending aorta is a primary arterial access for antegrade systemic perfusion.
• Prompt perfusion is crucial in acute type A aortic dissection, especially in hemodynamically unstable patients, to prevent organ damage and embolism.
• Evaluating the effectiveness and safety of antegrade perfusion via the dissected ascending aorta using ultrasonographic guidance and a new echo stabilizer is essential.

Purpose of the Study:

• To evaluate the effectiveness and safety of antegrade perfusion through the dissected ascending aorta using ultrasonographic guidance.
• To assess a new echo stabilizer-assisted cannulation method for type A aortic dissection repair.

Main Methods:

• Ascending aortic cannulation was performed using the Seldinger technique in 64 consecutive patients.
• A hands-free, continuous-echo monitoring system with a new stabilizer was employed.
• Epiaortic 2-Dimensional and color Doppler imaging provided real-time monitoring during cannulation and perfusion.

Main Results:

• Successful ascending aortic cannulation was achieved in all 64 patients.
• The echo-guided stabilizer-assisted method allowed for real-time monitoring of cannulation and perfusion.
• This technique facilitated proper placement and effective perfusion of the ascending aorta.

Conclusions:

• The ascending aorta serves as a routine, rapid, and reliable route for antegrade central systemic perfusion in type A acute aortic dissection.
• The echo-guided stabilizer-assisted cannulation method is safe and effective for antegrade central perfusion during type A dissection repair.