AUTHOR=Xie Yi , Liu Yu , Yang Peng , Lu Chen , Hu Jia 

TITLE=Comparison of Post-operative Outcomes Between Direct Axillary Artery Cannulation and Side-Graft Axillary Artery Cannulation in Cardiac Surgery: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.925709

DOI=10.3389/fcvm.2022.925709

ISSN=2297-055X

ABSTRACT=Background: There is a growing perception of using axillary artery cannulation to improve operative outcomes in cardiopulmonary bypass surgery. Two techniques, direct cannulation or side-graft cannulation, can be used for axillary artery cannulation, but which technique is better is controversial.
Methods: A meta-analysis of comparative studies reporting operative outcomes using direct cannulation versus side-graft cannulation was performed. we searched the PubMed, EMbase, Web of Science, and Cochrane Library. Outcomes of interest were neurological dysfunction, cannulation-related complications and early mortality. The fixed effects model was used.
Results: A total of 1543 patients were included in the final analysis. Direct cannulation was used in 846 patients, and side-graft cannulation was used in 697 patients. Meta-analysis showed a higher  occurrence of neurological Complication in direct cannulation group [odds ratio, 1.49, 95% CI (1.03, 2.16), χ2 = 6.70, P =0.03] and a significantly higher incidence of cannulation-related complications in the direct cannulation group [odds ratio, 3.12, 95% CI (1.87, 5.18), χ2 = 2.54, P ＜0.0001] . The incidence of early mortality did not have a difference [odds ratio, 0.95, 95% CI (0.64, 1.41), χ2 = 6.35, P = 0.79].
Conclusions: This study suggests that side-graft axillary artery cannulation is a better strategy as it reduces the incidence of neurological dysfunction and cannulation-related complications.
Prospero number: CRD42022325456.