Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Perfusion techniques for acute aortic dissection type A (stanford)

Authors: M.N. Mukharyamov 1,2 , 2 , I.I. Vagizov 1 , I.M. Rakhimullin 1 , R.K. Dzhordzhikiya 1,2 , 2

Company:
1 Interregional Clinical and Diagnostic Center, Ministry of Health of the Tatarstan Republic, ul. Karbysheva, 12A, Kazan, 420101, Russian Federation;
2 Kazan State Medical University, Ministry of Health of the RF, ul. Butlerova, 49A, Kazan, 420012, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2015; (): -

Quote as: Mukharyamov M.N., Vagizov I.I., Rakhimullin I.M., Dzhordzhikiya R.K.. Perfusion techniques for acute aortic dissection type A (stanford). Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2015; 3: 21-26 (in Russ.)

Full text:  

Abstract

Objective – evaluation of results of surgical treatment of acute type A aortic dissection regarding the arterial line of cardiopulmonary bypass canulation site.

Material and methods. 49 patients with the mean age 46±12 years (22–71, 37 male) operated from 2007 till 2012 were retrospectively included in the study. The whole cohort was divided on 3 groups depending on canulation site (subclavian artery, innominate artery, femoral artery).

Results. Femoral arterial cannulation was associated with an increased risk of neurologic dysfunction comparing with those with antegrade perfusion (p=0.0443). Peripheral or organ malperfusion syndrome (p<0.0001), preoperative hemodynamic instability (p<0.0001) were linked with increased perioperative mortality.

Conclusions. Antegrade true lumen perfusion with an opportunity for unilateral antegrade cerebral perfusion during circulatory arrest threw subclavian or innominate artery leads to improved mortality and neurological morbidity levels comparing with the retrograde perfusion of femoral artery and total circulatory arrest. The advantage of subclavian artery comparing to innominate artery is the opportunity to connect an arterial line of cardiopulmonary bypass before sternotomy for securing massive irreparable bleeding.

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