60-day survival rate under treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique

Main Article Content

Surakarn Saraithong, MD
Phunlerd Piyaraj, MD, PhD
Susumu Oshima, MD
Junichi Shimamura
Takuya Fujikawa
Reo Kasai
Kensuke Ozaki
Shigeru Sakurai
Shiro Sasaguri
Shin Yamamoto, MD

Abstract

OBJECTIVE: The aim of this study was to show a technique and the results of 60-day survival rate under treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique.

MATERIAL AND METHODS: The data has been investigated through 12 years surgery experience since June 2003 in Acute Type A Acute Aortic Dissection by Transapical Aortic Cannulation Technique. This study was approved and reviewed by the ethical committee of the Kawasaki Saiwai Hospital, Kawasaki, Japan. Statistical Analysis: Cox proportional hazard regression was employed to analyze risk ratio, and Kaplan Meier curve was used to estimate the survival time. Statistically were significant at p < 0.05.

RESULTS: The study population (n =309) was investigated for survival analysis. The person-time was 6363.50 person/months. We found that, the death outcome was 29 persons (9.38%). The mortality rate was 4.55/1000 person/months (95% Confidence Interval = 3.17-6.56/1000 person-month)

CONCLUSION: Risk factors influencing the survival rate in Acute Type A Aortic Dissection included Coronary Artery Disease, Preoperative Hemodynamic Deterioration, Total Arch Replacement, cardiopulmonary bypass technique using only Deep Hypothermic Circulatory Arrest, Deep Hypothermic Circulatory Arrest with Retrograde Cerebral Perfusion and Deep Hypothermic Circulatory Arrest with Antegrade Selective Cerebral Perfusion. The enlargement of Ascending Aortic diameter and Proximal Descending Aorta diameter increased the death rate by 11% and 18%, respectively. Each time the diameter expanded 1 mm, and the operation time extended 1 minute, the death rate was increased by 1%.

Article Details

How to Cite
1.
Saraithong S, Piyaraj P, Oshima S, Shimamura J, Fujikawa T, Kasai R, Ozaki K, Sakurai S, Sasaguri S, Yamamoto S. 60-day survival rate under treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique. BKK Med J [Internet]. 2017 Feb. 20 [cited 2024 Apr. 24];13(1):13. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/221772
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Original Article

References

1. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 2000;283: 897-903
2. Yamamoto S, Hosoda Y, Yamasaki M, et al. Transapical aortic cannulation for acute aortic dissection to prevent malperfusion and cerebral complications. Tex Heart Inst J. 2001;28(1):42-3.
3. Golding LA. New cannulation technique for the severely calcified ascending aorta. J Thorac Cardiovasc Surg 1985;90:626-7.
4. Shimokawa T, Takanashi S, Ozawa N, et al. Management of intraoperative malperfusion syndrome using femoral artery cannulation for repair of acute type A aortic dissection. Ann Thorac Surg 2008;8:1619-24.
5. Fusco DS, Shaw RK, Tranquilli M, et al. Femoral cannulation is safe for type A dissection repair. Ann Thorac Surg 2004;78:1285-9.
6. Orihashi K, Sueda T, Okada K. Detection and monitoring of complications associated with femoral or axillary arterial cannulation for surgical repair of aortic dissection. J Cardiothorac Vasc Anesth 2006;20:20-5.
7. Reuthebuch O, Schurr U, Hellermann J, et al. Advantages of subclavian artery perfusion for repair of acute type A dissection. Eur J Cardiothorac Surg 2004;26:592-8.
8. Reece TB, Tribble CG, Smith RL, et al. Central cannulation is safe in acute aortic dissection repair. J Thorac Cardiovasc Surg 2007;133:428-34.
9. Chiappini B, Schepens M, Tan E, et al. Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients. Eur Heart J 2005;26:180-6.
10. Moizumi Y, Motoyoshi N, Sakuma K, et al. Axillary artery cannulation improves operative results for acute type A aortic dissection. Ann Thorac Surg 2005;80: 77-83.
11. Nouraei SM, Nouraei SAR, Sadashiva AK, et al. Subclavian cannulation improves outcome of surgery for type A aortic dissection. Asian Cardiovasc Thorac Ann 2007;15:118-22.
12. Lee HK, Kim GJ, Cho JY. Comparison of the Outcomes between Axillary and Femoral Artery for Acute Type A Aortic Dissection. Korean J Thorac Cardiovasc Surg 2012; 45:85-90.
13. Tiwari KK, Murzi M, Bevilacqua S. Which cannulation (ascending aortic cannulation or peripheral arterial cannulation) is better for acute type A aortic dissection surgery? Interact Cardiovasc Thorac Surg 2010;10:797-802.
14. Immer FF, Moser B, Krähenbühl ES. Arterial access through the right subclavian artery in surgery of the aortic arch improves neurologic outcome and mid-term quality of life. Ann Thorac Surg 2008;85:1614-8.
15. Kamiya H, Kallenbach K, Halmer D, et al. Comparison of ascending aorta versus femoral artery cannulation for acute aortic dissection type A. Circulation 2009;120:S282-S286.
16. Khaladj N, Shrestha M, Peterss S, et al. Ascending aortic cannulation in acute aortic dissection type A: the Hannover experience. Eur J Cardiothorac Surg 2008;32:792-7.
17. Conzelmann LO, Weigang E, Mehlhorn U, et al. How to do it: direct true lumen cannulation technique of the ascending aorta in acute aortic dissection type A. Interact Cardiovasc Thorac Surg 2012;14(6):869-70.
18. Inoue Y, Takahashi R, Ueda T, et al. Synchronized epiaortic two-dimensional and color Doppler echocar- diographic guidance enables routine ascending aortic cannulation in type A acute aortic dissection. J Thorac Cardiovasc Surg 2011;141:354-60.
19. Di Eusanio M, Ciano M, Labriola G, et al. Cannulation of the innominate artery during surgery of the thoracic aorta: our experience in 55 patients. Eur J Cardiothorac Surg 2007;32: 270-3.
20. Urbanski PP, Lenos A, Lindemann Y. Carotid artery cannulation in aortic surgery. J Thorac Cardiovasc Surg 2006;132:1398- 403.
21. Matsushita A, Manabe S, Tabata M, et al. Efficacy and pitfalls of transapical cannulation for the repair of acute type A aortic dissection. Ann Thorac Surg 2012;93: 1905-9.
22. Wada S, Yamamoto S, Honda J, et al. Transapical aortic cannulation for cardiopulmonary bypass in type A aortic dissection operations. J Thorac Cardiovasc Surg 2006;132: 369-72.
23. Zwart HH, Kralios A, Kwan-Gett CS, et al. First clinical application of transarte- rial closed-chest left ventricular (TaCLV) bypass. Trans Am Soc Artif Intern Organs 1970;16:386-91.
24. Robicsek F. Apical aortic cannulation: application of an old method with new paraphernalia. Ann Thorac Surg 1991;51: 330-2.