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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

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Published on: March 28, 2025

821

Left Ventricular Apical Cannulation in Acute Type A Aortic Dissection.

Benedetto Ferraresi1, Antonio Nenna2, Mohamad Jawabra1

  • 1Cardiac Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Rome, Italy.

Journal of Cardiovascular Development and Disease
|November 26, 2025
PubMed
Summary
This summary is machine-generated.

Transapical left ventricular cannulation (TAC) offers rapid cardiopulmonary bypass and antegrade flow for acute type A aortic dissection. This approach is valuable when conventional cannulation is unsafe, with comparable outcomes to other methods.

Keywords:
aortic dissectioncannulationcomplicationemergencytranscatheter

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Arterial cannulation site selection critically impacts hemodynamics and organ protection in acute type A aortic dissection.
  • Transapical left ventricular cannulation (TAC) is a proposed central approach for rapid cardiopulmonary bypass and antegrade true-lumen flow.
  • Evidence on TAC for acute type A dissection, including indications, techniques, and outcomes, requires summarization.

Purpose of the Study:

  • To review current evidence on transapical left ventricular cannulation (TAC) in acute type A aortic dissection.
  • To focus on the indications, technical aspects, and clinical outcomes of TAC.
  • To evaluate TAC as a primary or bail-out cannulation strategy.

Main Methods:

  • Conducted a narrative review of observational studies and technical reports on TAC for acute type A aortic dissection repair.
  • Focused on patient selection, operative technique, perioperative complications, and early to mid-term results.
  • Emphasized echocardiographic guidance for cannula placement in the ascending aorta's true lumen.

Main Results:

  • TAC is primarily used in hemodynamically unstable patients or when peripheral arteries are unsuitable.
  • This technique enables rapid cardiopulmonary bypass initiation and reliable antegrade inflow.
  • Early mortality and stroke rates are comparable to other cannulation strategies, with manageable complications like malperfusion and apical bleeding.

Conclusions:

  • TAC is a valuable bail-out and primary option for acute type A aortic dissection when conventional access is compromised.
  • It provides fast, reproducible antegrade true-lumen flow but requires specialized expertise.
  • Integration into a structured perfusion and repair strategy is recommended for optimal outcomes.