Femoral Arterial Cannulation Provides Excellent Results for Aortic Dissection Repair

It was a retrospective study on 52 patients who underwent surgical repair for a type A dissection between January 2012 and June 2019 at a single institution. Among 52 patients analyzed, 35 (67.3%) underwent femoral artery, 11 (21.2%) direct ascending aortic, and 6 (11%) axillary artery cannulation for arterial access. The researchers used deep hypothermic circulatory arrest in all patients, and reported the rates of postoperative mortality and complication.

Key findings of the study were:

• Upon analysis, the researchers observed that the rate of mortality and bleeding for all the patients undergoing repair of the type A dissection repairs were 27% (14/52) and 19% (10/52).
• In all patients with femoral arterial cannulation, cardiopulmonary bypass was established. The researchers observed no complications, specifically relating to the three cannulation approaches.
• They found that the bleeding rate for patients with femoral cannulation (13%) was higher compared with the rate for the other cannulation approaches (6%). However, they noted that neither of the bleeding was related to the cannulation site.
• They also noted that none of the mortalities identified were directly attributable to the cannulation approach in each case.

The authors concluded, "Despite the recent shift away from femoral cannulation, the results of the study show that femoral artery cannulation is safe and produces excellent results for establishing cardiopulmonary bypass. The concerns for malperfusion syndrome related to femoral cannulation were not seen."

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