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J Thorac Cardiovasc Surg 2003;125:952-953
© 2003 The American Association for Thoracic Surgery

Brief Communications

Ascending aortic cannulation for Stanford type A acute aortic dissection: Another option

Kenji Minatoya, MD, Matthias Karck, MD, Eugeniusz Szpakowski, MD, Wolfgang Harringer, MD, Axel Haverich, MD Hannover, Germany

From the Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.

Received for publication Dec 18, 2001. Accepted for publication Aug 16, 2002. Address for reprints: Matthias Karck, MD, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, D-30623 Hannover, Germany.

The first 20% of the full text of this article appears below.

Stanford type A acute aortic dissection (AADA) is still a surgical challenge. Femoral cannulation remains the standard option for surgical repairs of AADA. However, retrograde perfusion has a potential risk of embolization of atheromatous debris, extension of dissection, and malperfusion. We hereby present our experiences with direct cannulation of the dissected ascending aorta in patients with AADA (Figure 1).


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  		Fig. 1.

 
Clinical summary

Between January 1998 and September 2000, 41 patients had a surgical repair of AADA with median sternotomy in our hospital. Among this population, 14 patients had ascending aortic or proximal arch cannulation to initiate cardiopulmonary bypass (CPB). Nine patients had DeBakey type I and 5 had DeBakey type II aortic dissection. CPB was initiated with aortic cannulation at the dissected site in all but 4 of the patients with DeBakey type II aortic dissection. There were 4 female and 6 male patients aged 59 ± 11 years (range, 41-77 years). . . . [Full Text of this Article]






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