Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study

Abstract Background Cannulation strategy in surgery for acute type A aortic dissection (ATAAD) remains controversial. We aimed to retrospectively analyze the safety and efficacy of double arterial cannulation (DAC) compared with right axillary cannulation (RAC) for ATAAD. Methods From January 2016 t...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	He Zhang, Wei Xie, Yuzhou Lu, Tuo Pan, Qing Zhou, Yunxing Xue, Dongjin Wang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Aortic dissection Cannulation Malperfusion Surgery RD1-811 Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/bf6157ce827b4a44abb019679da74b22
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:bf6157ce827b4a44abb019679da74b22
record_format	dspace
spelling	oai:doaj.org-article:bf6157ce827b4a44abb019679da74b222021-11-14T12:33:54ZDouble arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study10.1186/s13019-021-01714-51749-8090https://doaj.org/article/bf6157ce827b4a44abb019679da74b222021-11-01T00:00:00Zhttps://doi.org/10.1186/s13019-021-01714-5https://doaj.org/toc/1749-8090Abstract Background Cannulation strategy in surgery for acute type A aortic dissection (ATAAD) remains controversial. We aimed to retrospectively analyze the safety and efficacy of double arterial cannulation (DAC) compared with right axillary cannulation (RAC) for ATAAD. Methods From January 2016 to December 2018, 431 ATAAD patients were enrolled in the study. Patients were divided into DAC group (n = 341) and RAC group (n = 90). Propensity score matching analysis was performed to compare the early and mid-term outcomes between these two groups. To confirm the organ protection effect by DAC, intraoperative blood gas results and cardiopulmonary bypass parameters were compared between the two groups. Results Demographics and preoperative comorbidities were comparable between two groups, while patients in DAC group were younger than RAC group (51.55 ± 13.21 vs. 56.07 ± 12.16 years, P < 0.001). DAC had a higher incidence of limb malperfusion (18.2% vs. 10.0%, P = 0.063) and lower incidence of coronary malperfusion (5.3% vs. 12.2%, P = 0.019). No significant difference in cardiopulmonary bypass and cross-clamp time was found between the two groups. The in-hospital mortality was 13.5% (58/431), while there was no difference between the two groups (13.5% vs. 13.3%; P = 0.969). Patients who underwent DAC had higher incidence of postoperative stroke (5.9% vs. 0%, P = 0.019) and lower incidence of postoperative acute kidney injury (AKI) (24.7% vs. 40.3%; P = 0.015). During a mean follow-up period of 31.8 (interquartile range, 25–45) months, the overall survival was 81.5% for DAC group and 78.0% for RAC group (P = 0.560). Intraoperative blood gas results and cardiopulmonary bypass parameters showed that DAC group had more intraoperative urine output volume than RAC group (P = 0.05), and the time of cooling (P = 0.04) and rewarming (P = 0.04) were shorter in DAC group. Conclusions DAC will not increase the surgical risks compared to RAC, but could reduce the incidence of postoperative AKI which may be benefit for renal protection.He ZhangWei XieYuzhou LuTuo PanQing ZhouYunxing XueDongjin WangBMCarticleAortic dissectionCannulationMalperfusionSurgeryRD1-811AnesthesiologyRD78.3-87.3ENJournal of Cardiothoracic Surgery, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Aortic dissection Cannulation Malperfusion Surgery RD1-811 Anesthesiology RD78.3-87.3
spellingShingle	Aortic dissection Cannulation Malperfusion Surgery RD1-811 Anesthesiology RD78.3-87.3 He Zhang Wei Xie Yuzhou Lu Tuo Pan Qing Zhou Yunxing Xue Dongjin Wang Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study
description	Abstract Background Cannulation strategy in surgery for acute type A aortic dissection (ATAAD) remains controversial. We aimed to retrospectively analyze the safety and efficacy of double arterial cannulation (DAC) compared with right axillary cannulation (RAC) for ATAAD. Methods From January 2016 to December 2018, 431 ATAAD patients were enrolled in the study. Patients were divided into DAC group (n = 341) and RAC group (n = 90). Propensity score matching analysis was performed to compare the early and mid-term outcomes between these two groups. To confirm the organ protection effect by DAC, intraoperative blood gas results and cardiopulmonary bypass parameters were compared between the two groups. Results Demographics and preoperative comorbidities were comparable between two groups, while patients in DAC group were younger than RAC group (51.55 ± 13.21 vs. 56.07 ± 12.16 years, P < 0.001). DAC had a higher incidence of limb malperfusion (18.2% vs. 10.0%, P = 0.063) and lower incidence of coronary malperfusion (5.3% vs. 12.2%, P = 0.019). No significant difference in cardiopulmonary bypass and cross-clamp time was found between the two groups. The in-hospital mortality was 13.5% (58/431), while there was no difference between the two groups (13.5% vs. 13.3%; P = 0.969). Patients who underwent DAC had higher incidence of postoperative stroke (5.9% vs. 0%, P = 0.019) and lower incidence of postoperative acute kidney injury (AKI) (24.7% vs. 40.3%; P = 0.015). During a mean follow-up period of 31.8 (interquartile range, 25–45) months, the overall survival was 81.5% for DAC group and 78.0% for RAC group (P = 0.560). Intraoperative blood gas results and cardiopulmonary bypass parameters showed that DAC group had more intraoperative urine output volume than RAC group (P = 0.05), and the time of cooling (P = 0.04) and rewarming (P = 0.04) were shorter in DAC group. Conclusions DAC will not increase the surgical risks compared to RAC, but could reduce the incidence of postoperative AKI which may be benefit for renal protection.
format	article
author	He Zhang Wei Xie Yuzhou Lu Tuo Pan Qing Zhou Yunxing Xue Dongjin Wang
author_facet	He Zhang Wei Xie Yuzhou Lu Tuo Pan Qing Zhou Yunxing Xue Dongjin Wang
author_sort	He Zhang
title	Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study
title_short	Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study
title_full	Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study
title_fullStr	Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study
title_full_unstemmed	Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study
title_sort	double arterial cannulation versus right axillary artery cannulation for acute type a aortic dissection: a retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/bf6157ce827b4a44abb019679da74b22
work_keys_str_mv	AT hezhang doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy AT weixie doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy AT yuzhoulu doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy AT tuopan doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy AT qingzhou doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy AT yunxingxue doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy AT dongjinwang doublearterialcannulationversusrightaxillaryarterycannulationforacutetypeaaorticdissectionaretrospectivestudy
_version_	1718429191146307584

Double arterial cannulation versus right axillary artery cannulation for acute type A aortic dissection: a retrospective study

Ejemplares similares