Wang Lei1, Wang Zhen Hong2, Chen Xin1* and Li Ming Wang1
1Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, China
2Department of Anesthesiology Nanjing First Hospital, Nanjing Medical University, China
Objective: To compare the application and outcome of femoral and axillary arterial cannulation in adult type A aortic dissection surgery.Methods: 108 patients underwent type A aortic dissection surgery were divided into as the femoral artery cannulation group (n=53) and the axillary artery cannulation group (n=55) according to intraoperative arterial cannulation. General condition, cardiopulmonary bypass time and postoperative major complication retrospectively reviewed and compared between. Multivariate logistic analysis models were used to identify the independent predictors of risk factors of death.Result: Operative mortality was not influenced by cannulation site (18.1% for axillary cannulation vs.15.1% for femoral cannulation. Multivariate logistic analysis showed that age (age ≥ 70 years) and extracorporeal cardiopulmonary bypass time (CPB ≥ 250 min) were independent risk factors for surgical death. Early stoke renal injury and cognitive dysfunction was comparable between the groups.Conclusion: The outcomes of femoral versus axillary arterial cannulation in patients with acute type A aortic dissection are comparable. The choice of arterial cannulation site should be individualized based on different patient risk profiles. In addition, pre-operative hemodynamic instability, CPB time and body mass index (BMI ≥ 30 kg/m2) are independent risk factors of operative death.
Type A aortic dissection surgery; Cannulation; Outcome
Lei W, Hong WZ, Xin C, Wang LM. Comparison of Outcomes between Axillary and Femoral Artery Cannulation for Type A Aortic Dissection Surgery. Clin Surg. 2019; 4: 2312.