Korean Circ J. 2026 Apr 6. doi: 10.4070/kcj.2025.0303. Online ahead of print.
ABSTRACT
OBJECTIVE: The purpose of this study was to assess the safety and efficacy of aortic cannulation in comparison with right axillary artery (RAX) cannulation.
METHODS: Between 2018 and 2023, 267 and 364 patients underwent aortic or axillary cannulation for aortic repair for acute type A aortic dissection (ATAAD), respectively. Clinical features and outcomes were compared after inverse probability of treatment weighting was stabilized.
RESULTS: In the original cohort, patients in the aortic group had higher incidences of innominate artery (IA) dissection (59.6% vs. 45.1%, p<0.001), RAX dissection (13.9% vs. 4.7%, p<0.001), and right common carotid artery (RCCA) dissection (42.7% vs. 13.7%, p<0.001). After weighting, baseline characteristics were well balanced, resulting in a pseudo-cohort of aortic (n=265) vs. RAX (n=357) patients. Aortic cannulation was associated with a lower rate of cannulation-related complications (0.4% vs. 3.5%, p=0.011). In-hospital mortality (8.3% vs. 6.1%, p=0.346) and stroke rates (4.1% vs. 5.8%, p=0.383) were comparable between groups. The aortic group experienced lower rates of reoperation for bleeding (8.0% vs. 2.3%, p=0.001) and extracorporeal membrane oxygenation use (5.0% vs. 2.0%, p=0.046). Mid-term survival did not differ significantly before (p=0.849) or after weight stabilization (p=0.345).
CONCLUSION: Direct aortic cannulation in ATAAD provides in-hospital and mid-term outcomes that are not statistically different from those with axillary cannulation. Aortic cannulation offers an alternative to axillary cannulation, especially for patients with IA/RAX/RCCA dissection.
PMID:42144753 | DOI:10.4070/kcj.2025.0303