Korean J Thorac Cardiovasc Surg.  2012 Apr;45(2):85-90. 10.5090/kjtcs.2012.45.2.85.

Comparison of the Outcomes between Axillary and Femoral Artery Cannulation for Acute Type A Aortic Dissection

• Lee HK
• Kim GJ
• Cho JY
• Lee JT
• Park I
• Lee YO

• KMID: 1433668
• DOI: http://doi.org/10.5090/kjtcs.2012.45.2.85

Abstract

BACKGROUND
At present, many surgeons prefer axillary artery cannulation because it facilitates antegrade cerebral perfusion and may diminish the risk of cerebral embolization. However, axillary artery cannulation has not been established as a routine procedure because there is controversy about its clinical advantage.
MATERIALS AND METHODS
We examined 111 patients diagnosed with acute type A aortic dissection between January 2000 and December 2009. The right axillary artery was cannulated in 58 patients (group A) and the femoral artery was cannulated in 53 (group F). The postoperative outcomes were retrospectively reviewed and compared between the two groups.
RESULTS
There were 46 male and 65 female patients with a mean age of 58.9+/-13.1 years (range, 26 to 84 years). The extent of aortic replacement in both groups did not differ. There were 8 early deaths (7.2%) and 2 late deaths (1.8%). The mean follow-up duration was 46.0+/-32.6 months (range, 1 month to 10 years). Transient neurologic dysfunction was observed in 11 patients (19.0%) in group A and 14 patients (26.4%) in group F. A total of 11 patients (9.9%) suffered from a permanent neurologic dysfunction. Early and delayed stroke were observed in 6 patients (10.3%) and 2 patients (3.4%), respectively, in group A as well as 2 patients (3.8%) and 1 patient (1.9%), respectively, in group F. There were no statistical differences in the cannulation-related complications between both groups (3 in group A vs. 0 in group F).
CONCLUSION
There were no differences in postoperative neurologic outcomes and cannulation-related complications according to the cannulation sites. The cannulation site in an aortic dissection should be carefully chosen on a case-by-case basis. It is important to also pay attention to the possibility of intraoperative malperfusion syndrome occurring and the subsequent need to change the cannulation site.

Keyword

Aorta, surgery; Axillary artery; Femoral artery; Cardiopulmonary bypass; Cannulation

MeSH Terms

Axillary Artery
Cardiopulmonary Bypass
Catheterization
Cinnarizine
Female
Femoral Artery
Follow-Up Studies
Humans
Male
Neurologic Manifestations
Perfusion
Retrospective Studies
Stroke
Cinnarizine