Central cannulation is safe in acute aortic dissection repair

T. Brett Reece, Curtis G. Tribble, Robert L. Smith, R. Ramesh Singh, Brendon M. Stiles, Benjamin B. Peeler, John A. Kern, Irving L. Kron

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Objective: The site of cannulation for the repair of ascending aortic dissection remains controversial. It is not clear whether cannulation of the dissected vessel is safe or even preferred. We hypothesized that cannulation of the dissected aorta could be done safely with acceptable complication and mortality rates in this high-risk population. Methods: The charts of repairs of acute ascending aortic dissections (n = 70) from 1996 to 2005 were reviewed. Cannulation was accomplished in 24 patients via the dissected aorta (central) and in 46 patients through cannulation of the femoral or axillary artery (peripheral). All were converted to sidearm cannulation of the graft for reperfusion. Groups were compared on the basis of comorbidities in addition to mortality, complications, hospital stays and final disposition. Results: The groups were comparable on the basis of age and preoperative comorbidities. Similarly, there were no differences in bypass time, crossclamp time, or hypothermic circulatory arrest time between groups. Hospital mortality and postoperative complications, including stroke, were similar between groups, but the peripheral group experienced more cardiac events (peripheral 15% vs central 0%; P < .05) and higher mortality than the central group (peripheral 19.5% vs central 4.2%; P < .05). Conclusions: Direct cannulation of the dissected aorta was safe compared with peripheral cannulation in these patients. Inasmuch as these data demonstrate that cannulation of the dissected ascending aorta is safe, this technique can be used to tailor the cannulation approach to specific anatomic and patient characteristics that might optimize postoperative outcomes in this disease entity.

Original languageEnglish (US)
Pages (from-to)428-434
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume133
Issue number2
DOIs
StatePublished - Feb 1 2007
Externally publishedYes

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Catheterization
Dissection
Aorta
Mortality
Comorbidity
Axillary Artery
Femoral Artery
Hospital Mortality
Reperfusion
Length of Stay
Stroke
Transplants

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Reece, T. B., Tribble, C. G., Smith, R. L., Singh, R. R., Stiles, B. M., Peeler, B. B., ... Kron, I. L. (2007). Central cannulation is safe in acute aortic dissection repair. Journal of Thoracic and Cardiovascular Surgery, 133(2), 428-434. https://doi.org/10.1016/j.jtcvs.2006.09.059

Central cannulation is safe in acute aortic dissection repair. / Reece, T. Brett; Tribble, Curtis G.; Smith, Robert L.; Singh, R. Ramesh; Stiles, Brendon M.; Peeler, Benjamin B.; Kern, John A.; Kron, Irving L.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 133, No. 2, 01.02.2007, p. 428-434.

Research output: Contribution to journalArticle

Reece, TB, Tribble, CG, Smith, RL, Singh, RR, Stiles, BM, Peeler, BB, Kern, JA & Kron, IL 2007, 'Central cannulation is safe in acute aortic dissection repair', Journal of Thoracic and Cardiovascular Surgery, vol. 133, no. 2, pp. 428-434. https://doi.org/10.1016/j.jtcvs.2006.09.059
Reece TB, Tribble CG, Smith RL, Singh RR, Stiles BM, Peeler BB et al. Central cannulation is safe in acute aortic dissection repair. Journal of Thoracic and Cardiovascular Surgery. 2007 Feb 1;133(2):428-434. https://doi.org/10.1016/j.jtcvs.2006.09.059
Reece, T. Brett ; Tribble, Curtis G. ; Smith, Robert L. ; Singh, R. Ramesh ; Stiles, Brendon M. ; Peeler, Benjamin B. ; Kern, John A. ; Kron, Irving L. / Central cannulation is safe in acute aortic dissection repair. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 133, No. 2. pp. 428-434.
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AU - Singh, R. Ramesh

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AU - Peeler, Benjamin B.

AU - Kern, John A.

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