Comparison of high aortic arch and other arterial cannulation types in ascending aortic pathologies

Abstract

Background/Aim: Various cannulation techniques are used for different aortic pathologies during aortic surgery. High aortic arch cannulation is an easy technique which does not require a second incision. The aim of this study is to compare high aortic arch cannulation with other arterial cannulation techniques and assess its safety and risks profile. Methods: This retrospective study included sixty consecutive patients (23 female and 37 male) who underwent elective surgery for ascending aortic aneurysm between July 2011 and June 2014. Patients were divided into Group 1 (aortic arch cannulation) and Group 2 (femoral artery, axillary artery, innominate artery cannulations) according to the location of arterial cannulation. Preoperative, operative, and postoperative data of patients with or without arch cannulation were compared. Results: Ascending aorta was replaced with a graft in all patients. High aortic arch cannulation was performed in thirty-eight patients (63.3%) while the cannulation site was axillary artery in 9 (15%), femoral artery in 8 (13.3%) and innominate artery in 5 (8.3%) patients. There were no differences between the two groups in terms of preoperative demographic factors, concomitant cardiac pathologies, additional surgical procedures, and intraoperative parameters (P>0.05). Moreover, there was no difference between postoperative complications with the one exception of complications related to the cannulation site which was significantly more frequent in cannulation techniques other than arch cannulation (P=0.04). We observed no complications related to the cannulation site in patients with arch cannulation. Conclusion: Our study showed that high aortic arch cannulation in patients with ascending aortic aneurysms is an easy, fast, and safe technique with low complication rates. It can be the technique of first choice for those with ascending aortic aneurysms limited to ascending aorta with no place for cannulation, cross clamp and anastomosis but still can be repaired with single cross-clamping without total circulatory arrest.