Abstract
Type A aortic dissection most often requires emergent surgery to prevent
malperfusion, stroke, and/or rupture of aorta. The conduct of the
surgery is mostly targeted at restoring true lumen flow. In this regard,
institution of cardiopulmonary bypass and circulation management is key
to allow adequate systemic flow, perfusion of brain and visceral organs
and comprehensive systemic cooling to achieve circulatory arrest when
needed. Different strategies have been used with varying success rates,
with the most common being femoral cannulation. More recently axillary
and central cannulation strategies have shown satisfactory results with
the promise of antegrade flow. Cannulation approach should, therefore,
depend on individual patient characteristics, presentation and true
lumen anatomy.