Abstract
It remains controversial as to which optimal cannulation strategy ought to be employed in surgery for type A aortic dissection (TAAD). The aim of this study was to make a comparison of the clinical outcomes between single and double arterial cannulation. From January 2018 to December 2022, 403 individuals with TAAD were recruited for the study and were divided into two groups based on the cannulation approach. A total of 206 patients underwent single arterial cannulation, while 197 patients underwent double arterial cannulation. In order to balance the data encompassing specific pathological traits, stabilized inverse probability weighting (IPTW) was utilized. Confounding variables that could potentially be associated with the outcomes were adjusted by means of multivariate logistic regression analysis with IPTW. There was a significant difference in in-hospital mortality (19.9% versus 9.1% for single versus double arterial cannulation, respectively, P < 0.01). The incidence of stroke and acute kidney injury requiring dialysis was lower in the double arterial cannulation group than in the single artery cannulation group, but there was no statistical difference. Compared with the single arterial cannulation cohort, the IPTW adjusted odds ratios for in-hospital mortality and stroke in the double arterial cannulation cohort were 0.436 (95% CI, 0.211-0.903, P < 0.01) and 0.52 (95% CI, 0.3-0.89, P = 0.017), respectively. Double arterial cannulation served as a protective factor for in-hospital mortality and stroke. Consistent findings were noted upon stratification based on age, sex, BMI, and the duration of cardiopulmonary bypass. By providing stable systemic organ perfusion, the establishment of CPB with DAC can constitute a safe technique for TAAD repair.