Axillary vs Femoral Arterial Cannulation in Acute Type A Dissection: International Multicenter Data.
Publication/Presentation Date
3-6-2024
Abstract
BACKGROUND: Cannulation strategy in acute Type A dissection (ATAD) varies widely without known gold standards. We compared ATAD outcomes of Axillary versus Femoral cannulation in a large cohort from the International Registry of Acute Aortic Dissection (IRAD).
METHODS: We retrospectively reviewed 2145 IRAD Interventional Cohort patients (1996-2021) undergoing ATAD repair with axillary or femoral cannulation (Axillary: N=1106, 52%; Femoral: N=1039, 48%). Endpoints included: early mortality; neurologic, respiratory and renal complications; malperfusion; and tamponade. All outcomes are presented as axillary with respect to femoral.
RESULTS: The proportion of patients under age 70 in both groups was similar (N=1577, 74%) as were: bicuspid aortic valve, Marfan syndrome, and previous dissection. Femoral patients had slightly more aortic insufficiency [408 (55%) vs 429 (60%) p=0.058] and coronary involvement [48 (8%) vs 70 (13%) p=0.022]. Axillary patients underwent more total arch [156 (15%) vs 106 (11%) p=0.02] and valve-sparing root replacements [220 (22%) vs 112 (12%) p
CONCLUSIONS: Axillary cannulation is associated with more stable ATAD presentation, but more extensive intervention compared to Femoral. Both have equivalent early mortality, stroke, tamponade, and malperfusion outcomes after statistical adjustment.
ISSN
1552-6259
Published In/Presented At
Elbatarny, M., Trimarchi, S., Korach, A., Di Eusanio, M., Pacini, D., Bekeredjian, R., Myrmel, T., Bavaria, J. E., Desai, N. D., Sultan, I., Brinster, D. R., Pai, C. W., Eagle, K. A., Patel, H. J., Peterson, M. D., & IRAD Investigators (2024). Axillary vs Femoral Arterial Cannulation in Acute Type A Dissection: International Multicenter Data. The Annals of thoracic surgery, S0003-4975(24)00170-X. Advance online publication. https://doi.org/10.1016/j.athoracsur.2024.02.026
Disciplines
Medicine and Health Sciences
PubMedID
38458510
Department(s)
Department of Surgery
Document Type
Article