The cannulation strategy in surgery for acute type A dissection

Tomonobu Abe, Akihiko Usui

研究成果: Review article査読

29 被引用数 (Scopus)

抄録

The rates of mortality and morbidity remain high in surgery for acute type A dissection. There is controversy regarding the best cannulation strategy for achieving good clinical results. Each cannulation technique has different anatomical characteristics and a different flow pattern inside the aorta during cardiopulmonary bypass. Some adverse, clinically important outcomes may be related to events at this time. Femoral artery cannulation, axillary artery cannulation, and central aortic cannulation are the three major cannulation strategies that are adopted in many centers in the world. Accumulating results from comparative studies between right axillary artery cannulation and femoral artery cannulation show that right axillary artery cannulation is associated with better clinical outcomes. However, all of the studies have been retrospective, and few studies have compared the results of other combinations of cannulation strategies. Observational studies using newer monitoring techniques clearly show that no perfusion strategy is perfect or free from complications. In summary, the evidence is insufficient to make a strong recommendation regarding cannulation strategies. Based on the fairly consistent results of retrospective studies, more surgeons are tending to switch from a retrograde perfusion strategy to adopt an antegrade perfusion strategy. Regardless of the routine cannulation strategy that is adopted, careful monitoring and a swift response to adverse events are necessary. The further accumulation of evidence is warranted.

本文言語English
ジャーナルGeneral Thoracic and Cardiovascular Surgery
65
1
DOI
出版ステータスPublished - 01-01-2017
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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