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Central aortic versus axillary artery cannulation for aortic arch surgery

OBJECTIVE: Central aortic cannulation for aortic arch surgery has become more popular over the last decade; however, evidence comparing it with axillary artery cannulation remains equivocal. This study compares outcomes of patients who underwent axillary artery and central aortic cannulation for car...

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Autores principales: Chung, Megan M., Filtz, Kerry, Simpson, Michael, Nemeth, Samantha, Kosuri, Yaagnik, Kurlansky, Paul, Patel, Virendra, Takayama, Hiroo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328800/
https://www.ncbi.nlm.nih.gov/pubmed/37425444
http://dx.doi.org/10.1016/j.xjon.2023.01.017
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author Chung, Megan M.
Filtz, Kerry
Simpson, Michael
Nemeth, Samantha
Kosuri, Yaagnik
Kurlansky, Paul
Patel, Virendra
Takayama, Hiroo
author_facet Chung, Megan M.
Filtz, Kerry
Simpson, Michael
Nemeth, Samantha
Kosuri, Yaagnik
Kurlansky, Paul
Patel, Virendra
Takayama, Hiroo
author_sort Chung, Megan M.
collection PubMed
description OBJECTIVE: Central aortic cannulation for aortic arch surgery has become more popular over the last decade; however, evidence comparing it with axillary artery cannulation remains equivocal. This study compares outcomes of patients who underwent axillary artery and central aortic cannulation for cardiopulmonary bypass during arch surgery. METHODS: A retrospective review of 764 patients who underwent aortic arch surgery at our institution between 2005 and 2020 was performed. The primary outcome was failure to achieve uneventful recovery, defined as having experienced at least 1 of the following: in-hospital mortality, stroke, transient ischemic attack, bleeding requiring reoperation, prolonged ventilation, renal failure, mediastinitis, surgical site infection, and pacemaker or implantable cardiac defibrillator implantation. Propensity score matching was used to account for baseline differences across groups. A subgroup analysis of patients undergoing surgery for aneurysmal disease was performed. RESULTS: Before matching, the aorta group had more urgent or emergency operations (P = .039), fewer root replacements (P < .001), and more aortic valve replacements (P < .001). After successful matching, there was no difference between the axillary and aorta groups in failure to achieve uneventful recovery, 33% versus 35% (P = .766), in-hospital mortality, 5.3% versus 5.3% (P = 1), or stroke, 8.3% versus 5.3% (P = .264). There were more surgical site infections in the axillary group, 4.8% versus 0.4% (P = .008). Similar results were seen in the aneurysm cohort with no differences in postoperative outcomes between groups. CONCLUSIONS: Aortic cannulation has a safety profile similar to that of axillary arterial cannulation in aortic arch surgery.
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spelling pubmed-103288002023-07-09 Central aortic versus axillary artery cannulation for aortic arch surgery Chung, Megan M. Filtz, Kerry Simpson, Michael Nemeth, Samantha Kosuri, Yaagnik Kurlansky, Paul Patel, Virendra Takayama, Hiroo JTCVS Open Adult: Aorta OBJECTIVE: Central aortic cannulation for aortic arch surgery has become more popular over the last decade; however, evidence comparing it with axillary artery cannulation remains equivocal. This study compares outcomes of patients who underwent axillary artery and central aortic cannulation for cardiopulmonary bypass during arch surgery. METHODS: A retrospective review of 764 patients who underwent aortic arch surgery at our institution between 2005 and 2020 was performed. The primary outcome was failure to achieve uneventful recovery, defined as having experienced at least 1 of the following: in-hospital mortality, stroke, transient ischemic attack, bleeding requiring reoperation, prolonged ventilation, renal failure, mediastinitis, surgical site infection, and pacemaker or implantable cardiac defibrillator implantation. Propensity score matching was used to account for baseline differences across groups. A subgroup analysis of patients undergoing surgery for aneurysmal disease was performed. RESULTS: Before matching, the aorta group had more urgent or emergency operations (P = .039), fewer root replacements (P < .001), and more aortic valve replacements (P < .001). After successful matching, there was no difference between the axillary and aorta groups in failure to achieve uneventful recovery, 33% versus 35% (P = .766), in-hospital mortality, 5.3% versus 5.3% (P = 1), or stroke, 8.3% versus 5.3% (P = .264). There were more surgical site infections in the axillary group, 4.8% versus 0.4% (P = .008). Similar results were seen in the aneurysm cohort with no differences in postoperative outcomes between groups. CONCLUSIONS: Aortic cannulation has a safety profile similar to that of axillary arterial cannulation in aortic arch surgery. Elsevier 2023-03-01 /pmc/articles/PMC10328800/ /pubmed/37425444 http://dx.doi.org/10.1016/j.xjon.2023.01.017 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Adult: Aorta
Chung, Megan M.
Filtz, Kerry
Simpson, Michael
Nemeth, Samantha
Kosuri, Yaagnik
Kurlansky, Paul
Patel, Virendra
Takayama, Hiroo
Central aortic versus axillary artery cannulation for aortic arch surgery
title Central aortic versus axillary artery cannulation for aortic arch surgery
title_full Central aortic versus axillary artery cannulation for aortic arch surgery
title_fullStr Central aortic versus axillary artery cannulation for aortic arch surgery
title_full_unstemmed Central aortic versus axillary artery cannulation for aortic arch surgery
title_short Central aortic versus axillary artery cannulation for aortic arch surgery
title_sort central aortic versus axillary artery cannulation for aortic arch surgery
topic Adult: Aorta
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328800/
https://www.ncbi.nlm.nih.gov/pubmed/37425444
http://dx.doi.org/10.1016/j.xjon.2023.01.017
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