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Femoral arterial cannulation for surgical repair of stanford type A aortic dissection
T. Juvonen, I. Vendramin, G. Mariscalco, M. Jormalainen, A. Perrotti, A. Hervé, E. Mazzaro, G. Gatti, M. Pettinari, S. Peterss, J. Buech, F. Nappi, AG. Pinto, J. Rodriguez Lega, M. Pol, J. Rocek, P. Kacer, A. Rukosujew, K. Wisniewski, D. Piani,...
Language English Country United States
Document type Journal Article, Observational Study
Grant support
Sigrid Juséliuksen Säätiö
Sydäntutkimussäätiö
PubMed
38686961
DOI
10.1002/wjs.12203
Knihovny.cz E-resources
- MeSH
- Aortic Aneurysm, Thoracic surgery mortality MeSH
- Femoral Artery * surgery MeSH
- Aortic Dissection * surgery mortality MeSH
- Catheterization methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospital Mortality * MeSH
- Catheterization, Peripheral methods MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Propensity Score MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
BACKGROUND: The benefits and harms associated with femoral artery cannulation over other sites of arterial cannulation for surgical repair of acute Stanford type A aortic dissection (TAAD) are not conclusively established. METHODS: We evaluated the outcomes after surgery for TAAD using femoral artery cannulation, supra-aortic arterial cannulation (i.e., innominate/subclavian/axillary artery cannulation), and direct aortic cannulation. RESULTS: 3751 (96.1%) patients were eligible for this analysis. In-hospital mortality using supra-aortic arterial cannulation was comparable to femoral artery cannulation (17.8% vs. 18.4%; adjusted OR 0.846, 95% CI 0.799-1.202). This finding was confirmed in 1028 propensity score-matched pairs of patients with supra-aortic arterial cannulation or femoral artery cannulation (17.5% vs. 17.0%, p = 0.770). In-hospital mortality after direct aortic cannulation was lower compared to femoral artery cannulation (14.0% vs. 18.4%, adjusted OR 0.703, 95% CI 0.529-0.934). Among 583 propensity score-matched pairs of patients, direct aortic cannulation was associated with lower rates of in-hospital mortality (13.4% vs. 19.6%, p = 0.004) compared to femoral artery cannulation. Switching of the primary site of arterial cannulation was associated with increased rate of in-hospital mortality (36.5% vs. 17.0%; adjusted OR 2.730, 95% CI 1.564-4.765). Ten-year mortality was similar in the study cohorts. CONCLUSIONS: In this study, the outcomes of surgery for TAAD using femoral arterial cannulation were comparable to those using supra-aortic arterial cannulation. However, femoral arterial cannulation was associated with higher in-hospital mortality than direct aortic cannulation. TRIAL REGISTRATION: ClinicalTrials.gov registration code: NCT04831073.
Cardiac Surgery Molinette Hospital University of Turin Turin Italy
Cardiothoracic Department Udine University Hospital Udine Italy
Cardiovascular Surgery Department University Hospital Gregorio Marañón Madrid Spain
Chirurgie Cardio thoraco Vasculaire Cliniques Universitaire Saint Luc Brussel Belgium
Department of Cardiac Surgery Centre Cardiologique du Nord de Saint Denis Paris France
Department of Cardiac Surgery Centre Hospitalier Annecy Genevois Epagny Metz Tessy France
Department of Cardiac Surgery Glenfield Hospital Leicester UK
Department of Cardiac Surgery Martin Luther University Halle Wittenberg Halle Germany
Department of Cardiothoracic Surgery University Hospital Muenster Muenster Germany
Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany
Department of Medicine South Karelia Central Hospital University of Helsinki Lappeenranta Finland
Department of Thoracic and Cardiovascular Surgery University of Franche Comte Besancon France
Division of Cardiac Surgery University of Verona Medical School Verona Italy
Faculty of Medicine University of Oulu Oulu Finland
German Centre for Cardiovascular Research Partner Site Munich Heart Alliance Munich Germany
Heart and Lung Center Helsinki University Hospital University of Helsinki Helsinki Finland
Liverpool Centre for Cardiovascular Sciences Liverpool Heart and Chest Hospital Liverpool UK
LMU University Hospital Ludwig Maximilian University Munich Germany
National Centre for Global Health National Health Institute Rome Italy
References provided by Crossref.org
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