Efficacy Analysis Of Double Arterial Cannulation In The Treatment Of Stanford Type A Aortic Dissection

Objective:The purpose of this study is to investigate the clinical effect of cardiopulmonary bypass with double arterial cannulation in patients with Stanford A aortic dissection.Methods:The intubation methods of type A aortic dissection patients in cardiothoracic surgery of Nanjing Drum Tower Hospital were analyzed retrospectively from January 2016 to December 2018.In this retrospective cohort,there were 551 patients with type A dissection,341 of whom were intubated by axillary artery combined with femoral artery,double arterial cannulation(DAC),90 by right axillary cannulation(RAC).The early clinical prognosis and mid-term follow-up results before and after matching were analyzed and compared between the two groups.Result:Double arterial cannulation didn’t increase postoperative in-hospital mortality(p=0.969).Cox analysis showed that DAC didn’t increase the risk of mid-term death(p=0.46),preoperative limb malperfusion(p<0.001),postoperative acute kidney injury(p=0.031)and postoperative mesenteric malperfusion(p=0.001)were independent risk factors of mid-term death in patients with Stanford A aortic dissection.Both unmatched and propensity score-matched analyses were performed to show that double arterial cannulation can reduce the incidence of postoperative acute kidney injury)(p<0.05).Conclusion:Double arterial cannulation is safe and effective for Stanford A aortic dissection operation,which can reduce the incidence of postoperative acute renal injury.