Abstract

Treatment of Malperfusion during Surgery for Type A Aortic Dissection

Cardiac Surgery Unit and Perfusion Service, Policlinico G. Martino, University of Messina, Messina, Italy

Address correspondence to: Salvatore Lentini, MD, U.O.C. di Cardiochirurgia, Università di Messina, Viale Gazzi, 98125 Messina, Italy. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received: 28 November 2008
Accepted: 10 March 2009

Abstract

During surgery for acute type A aortic dissection, malperfusion may occur during cardiopulmonary bypass. Retrograde perfusion trough femoral cannulation is considered a predisposing factor. However, this may occur even with antegrade perfusion, because of the presence of multiple flaps or compression of the true lumen by the false lumen. In this particular setting, the aim is to reach a perfusion of the true lumen of the dissected aorta. A technique of epicardial ultrasound-guided direct cannulation of the dissected aorta’s true lumen by a Seldinger technique may help in those cases. We describe the technique with particular interest to the epicardial ultrasound control and the type of arterial cannula to be inserted by the Seldinger technique.