초록접수 현황
| 17F-030 | 구연 발표 |
Impact of Direct Ascending Aortic Cannulation for Aortic Arch Surgery
Woo Seung Jang, Jae-Bum Kim, Jae Hyun Kim
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
Purpose : The site of cannulation for aortic arch repair remains controversial. Although axillary artery cannulation gains more popularity over femoral cannulation, it also has drawbacks of long preparation time and risk of malperfusion. We evaluated the safety and effectiveness of direct ascending aortic cannulation using ultrasound-guided Seldinger technique during aortic arch repair.
Methods : Between 2013 and 2017, 65 patients underwent aortic arch repair (54 hemi-arch, 2 partial arch, 9 total arch) for acute type A aortic dissection (n = 45), chronic type A aortic dissection (n = 9), or aortic aneurysm (n = 11). Direct ascending aortic cannulation group(Central, n = 17) was compared with axillary and/or femoral artery cannulation group(Peripheral, n = 48). All data were retrieved from the medical records and retrospectively reviewed.
Results : In terms of mortality and morbidity, there was no difference between the two groups. Aortic rupture or malperfusion related to the direct ascending aorta cannulation was not occurred. CPB establishment after skin incision was faster in central group than peripheral group (39 vs. 55minutes, p = 0.001). And also, operation time were shorter in central group than peripheral one (279 vs 375 minutes, P < 0.001). There were no difference in ACC, CPB and TCA time between the two groups.
Conclusion : Direct ascending aortic cannulation was safe and fast compared with peripheral cannulation in aortic arch surgeries. Direct ascending aortic cannulation would be more useful in patients who need rapid establishment of antegrade systemic perfusion in the situations of hemodynamic instability or acute type A aortic dissection.
Methods : Between 2013 and 2017, 65 patients underwent aortic arch repair (54 hemi-arch, 2 partial arch, 9 total arch) for acute type A aortic dissection (n = 45), chronic type A aortic dissection (n = 9), or aortic aneurysm (n = 11). Direct ascending aortic cannulation group(Central, n = 17) was compared with axillary and/or femoral artery cannulation group(Peripheral, n = 48). All data were retrieved from the medical records and retrospectively reviewed.
Results : In terms of mortality and morbidity, there was no difference between the two groups. Aortic rupture or malperfusion related to the direct ascending aorta cannulation was not occurred. CPB establishment after skin incision was faster in central group than peripheral group (39 vs. 55minutes, p = 0.001). And also, operation time were shorter in central group than peripheral one (279 vs 375 minutes, P < 0.001). There were no difference in ACC, CPB and TCA time between the two groups.
Conclusion : Direct ascending aortic cannulation was safe and fast compared with peripheral cannulation in aortic arch surgeries. Direct ascending aortic cannulation would be more useful in patients who need rapid establishment of antegrade systemic perfusion in the situations of hemodynamic instability or acute type A aortic dissection.
책임저자: Jae Hyun Kim
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
발표자: Jae Hyun Kim, E-mail : jaemax31@gmail.com