• Sarah Yousef, James A Brown, Derek Serna-Gallegos, Forozan Navid, Jianhui Zhu, Floyd W Thoma, Valentino Bianco, Edgar Aranda-Michel, Carlos E Diaz-Castrillon, and Ibrahim Sultan.
• Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
• J. Thorac. Cardiovasc. Surg. 2024 Feb 1; 167 (2): 588595588-595.

ObjectiveThis study sought to evaluate the impact of central aortic versus peripheral cannulation on outcomes after acute type A aortic dissection repair.MethodsThis was an observational study using an institutional database of acute type A aortic dissection repairs from 2007 to 2021. Patients were stratified according to central, subclavian, or femoral cannulation. Kaplan-Meier survival estimation and multivariable Cox regression were performed.ResultsThe study population consisted of 577 patients who underwent acute type A aortic dissection repair. Of these, central cannulation was used in 490 patients (84.9%), subclavian cannulation was used in 54 patients (9.4%), and femoral cannulation was used in 33 patients (5.7%). Rates of peripheral vascular disease, aortic insufficiency moderate or greater, and cerebral malperfusion differed significantly among the groups, but baseline characteristics were otherwise comparable (P > .05). Operative mortality was lowest in the central cannulation group (9.8%), but this did not differ significantly among the groups. Kaplan-Meier survival estimates were similar among the groups. On multivariable Cox regression, cannulation strategy was not significantly associated with long-term survival.ConclusionsAcute type A aortic dissection repair can be safely performed through central aortic cannulation, with outcomes comparable to those obtained with subclavian or femoral cannulation.Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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