J Thorac Cardiovasc Surg 2007;134:547
© 2007 The American Association for Thoracic Surgery
Reply to the Editor
T. Brett Reece, MD,
John A. Kern, MD,
Benjamin B. Peeler, MD,
Curtis G. Tribble, MD,
Irving L. Kron, MD
University of Virginia, Department of Thoracic and Cardiovascular Surgery, Charlottesville, Va
We appreciate the comments of Drs Santini and Mazzucco on our study evaluating the safety of centrally cannulating ascending aortic dissections at the University of Virginia. As they point out, our study does have the limitations that are inherent to single-institution retrospective studies. We recognized this fact in designing the study; however, it was never our goal to prove that central cannulation is superior to the other techniques. We intentionally avoided making any statement or implication about the relative efficacy of this approach. The aim of the study was to show that central cannulation can be done safely in specific situations of ascending aortic dissection. As both Sanitini and Mazzucco’s experience and our manuscript state, central cannulation of the dissected aorta is a technique that can be a safe option for well-selected patients. Furthermore, the response to our publication has made us aware of a broader cumulative experience with this technique. This response has been overwhelmingly positive, both with anecdotal experiences and with two separate international presentations from Germany and Japan on the technique in the past year. We would be happy to participate in a clinical trial on the optimal site of cannulation for ascending aortic dissection should one arise. Again, we appreciate the feedback from Santini and Mazzucco and hope that their input has clarified our central message that central cannulation of the ascending aortic dissection is both feasible and safe for selected patients.
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How should I cannulate my next acute aortic dissection?
- Francesco Santini and Alessandro Mazzucco
J. Thorac. Cardiovasc. Surg. 2007 134: 545-547.
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