Central versus peripheral cannulation for acute type A aortic dissection: A meta-analysis of over 14,000 patients - 26/09/24
, Michel Pompeu Sá b, c, Xander Jacquemyn d, Sarah Yousef b, c, James A. Brown b, c, Derek Serna-Gallegos b, c, Ibrahim Sultan b, cAbstract |
Objective |
The optimal cannulation strategy for patients with acute type A aortic dissections (ATAAD) is unclear.
Methods |
A systematic search was performed to identify all studies comparing aortic and non-aortic cannulation in patients undergoing ATAAD repair. The primary endpoint was overall survival. The secondary endpoints were operative mortality, postoperative stroke, renal failure, renal replacement therapy, paraplegia, and mesenteric ischemia. Pooled meta-analyses with aggregated and reconstructed time-to-event data were performed.
Results |
Twenty-three studies were included (aortic: 3904; non-aortic: 10,719). Ten-year overall survival was 61.1 % and 58.4 % for aortic and non-aortic cannulation, respectively (HR 1.07; 95 % CI 0.92–1.25; p = 0.38). No statistically significant difference was observed for operative mortality (p = 0.10), stroke (p = 0.89), renal failure (p = 0.83), or renal replacement therapy (p = 0.77).
Conclusion |
Patients undergoing surgery for ATAAD can undergo aortic cannulation with similar outcomes to those who undergo non-aortic cannulation.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Aortic cannulation is safe in patients undergoing surgery for acute type A aortic dissection (ATAAD). |
• | Overall and operative mortality favor aortic cannulation in ATAAD, though this difference was not statistically significant. |
• | In patients undergoing aortic cannulation for ATAAD repair, female gender was associated with operative mortality. |
Keywords : Cannulation, Type A dissection, Central cannulation, Peripheral cannulation, Ascending aortic dissection
Plan
Vol 237
Article 115780- novembre 2024 Retour au numéro
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