Harky Amer, Wong Chris Ho Ming, Chan Jeffrey Shi Kai, Zaki Shady, Froghi Saied, Bashir Mohamad
Department of Vascular Surgery, Countess of Chester Hospital, Chester, UK.
Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
J Card Surg. 2018 Dec;33(12):818-825. doi: 10.1111/jocs.13962. Epub 2018 Dec 12.
The innominate artery is considered an alternative site for establishing cardiopulmonary bypass in surgical procedures involving the thoracic aorta. This systematic review examines the use of innominate artery cannulation in aortic surgery.
A systematic literature search was undertaken among the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all studies that utilized innominate artery cannulation for establishing cardiopulmonary bypass and providing cerebral perfusion in thoracic aortic surgery. The data were reviewed up to September 2018.
Acute type A aortic dissection contributed to 36% (n = 818) of the total 2,290 patients. 31.5% (n = 719) underwent surgery on the aortic root only; 54.5% (n = 1246) had ascending and hemi-arch replacement, while 11.5% had total aortic arch replacement and 2.5% had a frozen elephant trunk inserted. Postoperative stroke rate was 1.25% (n = 28), temporary neurological deficit was 4.8% (n = 111). All-cause 30-day mortality rate was 2.7% (n = 61).
Innominate artery cannulation is a safe technique in patients who undergo thoracic aortic surgery. It can be utilized, in selected cases, as a reliable route for establishing cardiopulmonary bypass and maintaining cerebral perfusion.
在涉及胸主动脉的外科手术中，无名动脉被视为建立体外循环的替代部位。本系统评价旨在研究无名动脉插管在主动脉手术中的应用。
在四个主要数据库（PubMed、Embase、Scopus和Ovid）中进行系统的文献检索，以确定所有在胸主动脉手术中利用无名动脉插管建立体外循环并提供脑灌注的研究。数据截至2018年9月进行回顾。
在2290例患者中，急性A型主动脉夹层占36%（n = 818）。仅31.5%（n = 719）的患者接受了主动脉根部手术；54.5%（n = 1246）的患者进行了升主动脉和半弓置换，而11.5%的患者进行了全主动脉弓置换，2.5%的患者植入了“象鼻”支架。术后卒中发生率为1.25%（n = 28），暂时性神经功能缺损发生率为4.8%（n = 111）。30天全因死亡率为2.7%（n = 61）。
无名动脉插管在接受胸主动脉手术的患者中是一种安全的技术。在某些情况下，它可作为建立体外循环和维持脑灌注的可靠途径。
