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Stamou SC, Gartner D, Kouchoukos NT, et al. Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?: An Old Problem Seeking New Solutions. Aorta (Stamford). 2016;4(4):115-123doi: 10.12945/j.aorta.2016.16.007.
Stamou, S. C., Gartner, D., Kouchoukos, N. T., Lobdell, K. W., Khabbaz, K., Murphy, E., & Hagberg, R. C. (2016). Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?: An Old Problem Seeking New Solutions. Aorta (Stamford, Conn.), 4(4), 115-123. https://doi.org/10.12945/j.aorta.2016.16.007
Stamou, Sotiris C, et al. "Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?: An Old Problem Seeking New Solutions." Aorta (Stamford, Conn.) vol. 4,4 (2016): 115-123. doi: https://doi.org/10.12945/j.aorta.2016.16.007
Stamou SC, Gartner D, Kouchoukos NT, Lobdell KW, Khabbaz K, Murphy E, Hagberg RC. Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?: An Old Problem Seeking New Solutions. Aorta (Stamford). 2016 Aug 01;4(4):115-123. doi: 10.12945/j.aorta.2016.16.007. eCollection 2016 Aug. PMID: 28097193; PMCID: PMC5217728.
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Aorta (Stamford). 2016 Aug 01;4(4):115-123. doi: 10.12945/j.aorta.2016.16.007. eCollection 2016 Aug.

Axillary Versus Femoral Arterial Cannulation During Repair of Type A Aortic Dissection?: An Old Problem Seeking New Solutions.

Aorta (Stamford, Conn.)

Sotiris C Stamou, Derek Gartner, Nicholas T Kouchoukos, Kevin W Lobdell, Kamal Khabbaz, Edward Murphy, Robert C Hagberg

Affiliations

  1. Department of Cardiovascular Surgery, Baystate Medical Center, Springfield, Massachusetts, USA.
  2. Division of Cardiothoracic Surgery, Missouri Baptist Medical Center, Saint Louis, Missouri, USA.
  3. Department of Thoracic and Cardiovascular Surgery, Sanger Heart and Vascular Institute, Carolinas Medical Center, Charlotte, North Carolina, USA.
  4. Division of Cardiac Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
  5. Thoracic and Cardiovascular Surgery, Spectrum Health, Fred and Lena Meijer Heart and Vascular Institute, Grand Rapids, Michigan, USA.
  6. Department of Cardiac Surgery, Hartford Hospital, Hartford, Connecticut, USA.

PMID: 28097193 PMCID: PMC5217728 DOI: 10.12945/j.aorta.2016.16.007

Abstract

BACKGROUND: The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute Type A aortic dissection with axillary or femoral artery cannulation.

METHODS: A total of 305 patients from five academic medical centers underwent acute Type A aortic dissection repair via axillary (

RESULTS: Operative mortality was not influenced by cannulation site (16% for axillary cannulation vs. 19% for femoral cannulation, p = 0.64). In multivariate logistic regression analysis, hemodynamic instability (p < 0.001) and prolonged cardiopulmonary bypass time (>200 min; p = 0.05) emerged as independent predictors of operative mortality. Stroke rates were comparable between the two techniques (14% for axillary and 17% for femoral cannulation, p = 0.52). Five-year actuarial survival was comparable between the groups (55.1% for axillary and 65.7% for femoral cannulation, p = 0.36). In Cox regression analysis, predictors of long-term mortality were: age (p < 0.001), stroke (p < 0.001), prolonged cardiopulmonary bypass time (p = 0.001), hemodynamic instability (p = 0.002), and renal failure (p = 0.001).

CONCLUSIONS: 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.

Keywords: Aorta; Aortic dissection; Axillary cannulation; Dissection; Femoral cammulation; Outcomes

References

  1. Eur J Cardiothorac Surg. 2005 Apr;27(4):634-7 - PubMed
  2. J Thorac Cardiovasc Surg. 2014 Dec;148(6):2936-43.e1-4 - PubMed
  3. JAMA. 2000 Feb 16;283(7):897-903 - PubMed
  4. Aorta (Stamford). 2014 Feb 01;2(1):22-7 - PubMed
  5. Interact Cardiovasc Thorac Surg. 2010 Apr;10(4):539-44 - PubMed
  6. Korean J Thorac Cardiovasc Surg. 2012 Apr;45(2):85-90 - PubMed
  7. J Thorac Cardiovasc Surg. 1999 Aug;118(2):324-9 - PubMed
  8. Ann Thorac Surg. 2004 Oct;78(4):1285-9; discussion 1285-9 - PubMed
  9. Ann Thorac Surg. 2014 Jan;97(1):78-85 - PubMed
  10. J Thorac Cardiovasc Surg. 2011 Dec;142(6):1478-81 - PubMed
  11. Eur J Cardiothorac Surg. 2014 Aug;46(2):156-66 - PubMed
  12. Ann Thorac Surg. 2004 Oct;78(4):1274-84; discussion 1274-84 - PubMed
  13. Tex Heart Inst J. 2005;32(2):189-93; discussion 185 - PubMed
  14. Circulation. 2009 Sep 15;120(11 Suppl):S282-6 - PubMed
  15. Eur J Cardiothorac Surg. 2002 Aug;22(2):313-5 - PubMed
  16. Ann Thorac Surg. 2004 Jul;78(1):103-8; discussion 103-8 - PubMed
  17. Ann Thorac Surg. 2007 Mar;83(3):1219-24 - PubMed
  18. Multimed Man Cardiothorac Surg. 2012 Jan 1;2012:mms004 - PubMed
  19. J Card Surg. 2004 Jul-Aug;19(4):338-42 - PubMed
  20. Ann Thorac Surg. 2010 Sep;90(3):731-7 - PubMed
  21. Mayo Clin Proc. 2009 May;84(5):465-81 - PubMed
  22. Ann Thorac Surg. 2013 Nov;96(5):1656-63 - PubMed
  23. Ann Thorac Surg. 2005 Jul;80(1):77-83 - PubMed
  24. Ann Thorac Surg. 2008 May;85(5):1619-24 - PubMed
  25. Eur J Cardiothorac Surg. 2002 Sep;22(3):445-7 - PubMed
  26. Interact Cardiovasc Thorac Surg. 2010 May;10 (5):797-802 - PubMed

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