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Central aortic versus axillary artery cannulation for aortic arch surgery
Megan M Chung1, Kerry Filtz2, Michael Simpson1
1Division of Cardiothoracic and Vascular Surgery, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY.
JTCVS Open
|July 10, 2023
Summary
Central aortic cannulation and axillary artery cannulation show similar safety for aortic arch surgery. This study found no significant differences in patient recovery outcomes between the two methods.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Central aortic cannulation is increasingly used for aortic arch surgery.
- Evidence comparing central aortic cannulation with axillary artery cannulation is inconclusive.
Purpose of the Study:
- To compare the postoperative outcomes of central aortic cannulation versus axillary artery cannulation in patients undergoing aortic arch surgery.
- To evaluate the safety and efficacy of these two cannulation techniques.
Main Methods:
- Retrospective review of 764 patients undergoing aortic arch surgery (2005-2020).
- Primary outcome: failure to achieve uneventful recovery (mortality, stroke, bleeding, prolonged ventilation, renal failure, infection, pacemaker/ICD implantation).
- Propensity score matching used to control for baseline differences; subgroup analysis for aneurysm surgery.
Main Results:
- After matching, no significant differences in uneventful recovery (33% vs 35%), in-hospital mortality (5.3% vs 5.3%), or stroke (8.3% vs 5.3%) between axillary and aorta groups.
- Surgical site infections were more frequent in the axillary artery group (4.8% vs 0.4%).
- Similar outcomes observed in the aneurysm subgroup.
Conclusions:
- Central aortic cannulation demonstrates a comparable safety profile to axillary artery cannulation for aortic arch surgery.
- No significant differences in major postoperative complications were found between the two techniques.
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