Double arterial vs. single axillary cannulation in acute type A aortic dissections: a meta-analysis.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Future cardiology Pub Date : 2024-04-25 Epub Date: 2024-07-04 DOI:10.1080/14796678.2024.2367875

Yoshiyuki Yamashita, Serge Sicouri, Aleksander Dokollari, Khalid Ridwan, Nicholas Clarke, Roberto Rodriguez, Scott Goldman, Basel Ramlawi

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Abstract

Aim: To evaluate the effects of double (axillary and femoral) vs. single (axillary) cannulation on early outcomes of acute type A aortic dissection (ATAAD). Materials & methods: Meta-analysis using PubMed/MEDLINE, Scopus, and Cochrane databases through August 23, 2023. Focused on operative mortality, postoperative stroke, re-exploration for bleeding, spinal cord injury, and renal replacement therapy. Results: Among 5 propensity score-matched studies with 2127 patients, double cannulation showed comparable mortality and higher rates of postoperative stroke (pooled odds ratio: 1.69, 95% confidence interval: 1.19-2.39) and need for renal replacement therapy (pooled odds ratio: 1.35, 95% confidence interval: 1.13-1.60) compared with single cannulation. Conclusion: Double arterial cannulation in ATAAD surgery is associated with increased postoperative stroke and renal replacement therapy than single cannulation.

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急性 A 型主动脉夹层中的双动脉插管与单腋窝插管：一项荟萃分析。

目的：评估双（腋窝和股骨）插管与单（腋窝）插管对急性 A 型主动脉夹层（ATAAD）早期预后的影响。材料与方法：使用 PubMed/MEDLINE、Scopus 和 Cochrane 数据库（截至 2023 年 8 月 23 日）进行 Meta 分析。重点关注手术死亡率、术后中风、因出血再次手术、脊髓损伤和肾脏替代治疗。结果：在 5 项有 2127 名患者的倾向评分匹配研究中，双插管与单插管相比，死亡率相当，但术后中风率（汇总几率比：1.69，95% 置信区间：1.19-2.39）和肾脏替代治疗需求率（汇总几率比：1.35，95% 置信区间：1.13-1.60）较高。结论与单动脉插管相比，ATAAD 手术中的双动脉插管与术后中风和肾脏替代治疗的增加有关。

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来源期刊

Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.80

自引率

5.90%

发文量

期刊介绍： Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.