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eComment: Rapid and safe establishment of cardiopulmonary bypass in repair of acute aortic dissection: improved results with double cannulation

Bakoulev Center for Cardiovascular Surgery, 121552 Moscow, Russia

Rapid and safe establishment of cardiopulmonary bypass in repair of acute aortic dissection: improved results with double cannulation

The surgical treatment of acute type I aortic dissection till now remains a difficult problem. High risks of development of malperfusion syndrome or neurologic complications both, up to and during operation result in increase hospital mortality.

Although the femoral artery has been widely chosen for cardiopulmonary bypass as an alternative arterial inflow to the diseased ascending aorta, complications due to retrograde perfusion, such as retrograde atheroembolism or organ malperfusion, have also been reported [1, 2]. The method of double cannulation, offered by the authors, allows quick establishment of cardiopulmonary bypass, and also avoids atheroembolism and organ malperfusion.

We want to congratulate the authors on their excellent results submitted in given abstract [3]. Efficiency of this technique specifies low hospital mortality rate (2.3%) and low frequency of perioperative stroke (5.7%).

The experience of our centre exceeds 130 cases of acute aortic dissection. We have begun to use right axillary artery cannulation since 2004. Since that time, the frequency of perioperative complications has decreased to 6.6%. Thus, we support the opinion of the authors on the necessity of axillary artery perfusion for the correction of acute type I aortic dissection.

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1. Borst HG. Surgical tactics and techniques, Borst HG, Heinemann MK, Stone CD, Surgical treatment of aortic dissection, 1st ed. New York: Churchill Livingstone; 1996:255–268.
2. Fusco DS, Shaw RK, Tranquilli M, Kopf GS, Elefteriades JA. Femoral cannulation is safe for type A dissection repair. Ann Thorac Surg 2004;78:1285–1289.[Abstract/Free Full Text]
3. Minatoya K, Ogino H, Matsuda H, Sasaki H. Rapid and safe establishment of cardiopulmonary bypass in repair of acute aortic dissection: improved results with double cannulation. Interact CardioVasc Thorac Surg 2008;7:951–953.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A. Articles by Rychin, S. V. Search for Related Content PubMed PubMed Citation Articles by Bockeria, L. A. Articles by Rychin, S. V. Related Collections Related Article