Aortic versus axillary artery cannulation for hemiarch replacement: single-centre real-world experience

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Aortic arch disease is a primary cause of acute dissections, often requiring surgical replacement.
• Traditional aortic cannulation ensures lower body perfusion, while axillary cannulation aims for optimal cerebral perfusion.

Purpose of the Study:

• To compare the outcomes of aortic versus axillary cannulation in hemiarch replacement surgeries.
• Focus on evaluating postoperative perfusion and survival rates between the two cannulation methods.

Main Methods:

• Retrospective analysis of 91 patients undergoing hemiarch replacement (February 2007 - October 2016).
• Patients divided into aortic cannulation (n=54) and axillary cannulation (n=37) groups.
• Analysis of preoperative, intraoperative, and postoperative parameters, including demographics, surgical outcomes, and complications.

Main Results:

• Axillary group had larger ascending aorta diameters and higher prevalence of acute dissections.
• Cerebral protection methods and patient temperatures varied significantly between groups.
• No significant differences in operative mortality or in-hospital outcomes; however, renal complications were more frequent in the axillary group.

Conclusions:

• No significant differences in safety and efficacy were found between axillary and aortic cannulation for hemiarch replacement.
• Both methods demonstrated comparable overall survival rates despite variations in specific complications.