The choice of arterial cannulation strategy for acute type A dissection surgery remains a controversial issue and a subject of great debate because of its impact on clinical outcomes. A review of retrospective studies shows that surgeons are tending to switch from a retrograde to an antegrade perfusion strategy. Innominate artery cannulation has a number of advantages when compared to other cannulation techniques; however when the vessel is dissected, the proximal right subclavian artery can be used for arterial return. Also, because cannulation of the right subclavian artery does not require a second surgical incision in addition to median sternotomy, this decreases the number of incision sites and further simplifies the procedure.
© The Author 2016. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.