Hospital outcomes of antegrade versus retrograde arterial cannulation in type A aortic dissection: A single center experience

Background

the aim of our study was to evaluate the impact of different cannulation strategies, retrograde and antegrade, on outcome of type A aortic dissection (TAAD) surgery and to identify the predictors of perioperative transient & permanent neurologic dysfunction.

Methods

Between March 2014 and September 2017, 50 patients with TAAD who underwent surgical repair of aortic dissection at Kasr Alainy Hospital, Cardiothoracic Surgery Department were divided into two equal groups: The first group had retrograde (femoral) cannulation, while the second group had antegrade cannulation (central, right axillary, and innominate artery).

Results

the mean age was 52.6 ± 7.55 years in the retrograde group and 46.5 ± 10.53 years in the antegrade group. There were 3 deaths in the retrograde group (12%) and 2 deaths in the antegrade group (8%). Transient neurologic dysfunction was observed in 4 patients (16%) in the first group and 0 patients (0%) in the second group. A total of 3 patients (12%) in the first group suffered from a permanent neurologic dysfunction to 2 patients (8%) in the second group.

Conclusions

The cannulation site in an aortic dissection should be carefully chosen on a case-by-case basis and larger study is recommended to better evaluate optimal cannulation technique.