Subclavian Artery Versus Femoral Artery Cannulation as An Access for Cardiopulmonary Bypass in Repair of Acute Type A Aortic Dissection

Abstract

Background: Although many studies have reported the advantages and disadvantages between subclavian and femoral and cannulation, however most of these studies reported results for all patients underwent deep hypothermic circulatory arrest (DHCA) with ascending and aortic arch surgery with different pathologies. Objective: In our study we compared femoral and subclavian artery cannulation and reported the results only for the ascending aorta with acute type A aortic dissection (ATAAD). Patients and Methods: From January 2017 to January 2018 in Cairo University Hospitals, we selected 100 patients presented with acute type A aortic dissection and underwent reconstruction of only the ascending aorta. Patients were divided into two groups, Group (A): includes patients with subclavian artery cannulation to establish cardiopulmonary bypass (CPB) and Group (B): includes patients with femoral artery cannulation to establish CPB. Early postoperative results during hospital stay and mortality were reported and compared between the groups. Results: The preoperative data in both groups showed no statistical difference in both groups, in postoperative data only Subclavian cannulation had a better cerebral protection and lower hospital stay than femoral cannulation (2 vs 8%, p = 0.04) while other postoperative data as well as mortality showed no statistical differences in both groups. Conclusions: From results of our study we concluded that subclavian cannulation is better than femoral cannulation in repair of type A aortic dissection as it has better cerebral protection and lower postoperative hospital stay.