ORIGINAL RESEARCH article
Front. Med.
Sec. Precision Medicine
This article is part of the Research TopicPrecision Medicine in Cardiovascular Remodeling: Bridging Pathogenesis to Personalized Therapeutic StrategiesView all 3 articles
Application of a Modified Perfusion Strategy via Anastomosis of the Innominate Artery with a 10-mm Artificial Vascular Graft in Acute Type AAortic Dissection
Provisionally accepted
- 1Xuzhou Central Hospital, Xuzhou, China
- 2The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Background Acute type A aortic dissection (ATAAD) necessitates emergent surgery with optimal cerebral protection. Traditional axillary artery cannulation carries risks of brachial plexus injury and inadequate perfusion. This study evaluates a modified technique using a 10-mm vascular graft anastomosed to the innominate artery to improve cerebral and systemic perfusion. Methods We retrospectively analyzed data from 94 consecutive ATAAD surgical patients between May 2024 and May 2025. All patients underwent hypothermic circulatory arrest (HCA) combined with antegrade cerebral perfusion (ACP). Perfusion was established via end-to-side anastomosis of a 10-mm straight artificial vascular graft to the innominate artery, through which both systemic arterial perfusion and ACP were conducted. Results In-hospital mortality was 14.89 %. Mean operative times included cardiopulmonary bypass (171.27 ± 43.65 min) and circulatory arrest (25 min). Complications included stroke (10.64 %), tracheostomy (17.02 %), and acute kidney injury (23.40 %). No upper limb ischemia or vascular injuries occurred. Conclusions The modified perfusion strategy utilizing innominate artery anastomosis with an artificial vascular graft is a safe, effective, and technically reliable method. It provides excellent cerebral perfusion, unobstructed surgical visibility, and avoids upper limb ischemic complications, making it worthy of clinical promotion.
Keywords: Acute type A aortic dissection, Innominate artery cannulation, antegrade cerebral perfusion, Cerebral protection, perfusion strategy, aortic surgery
Received: 11 Sep 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Lu, Zhou, Zhang, Wei and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun Wei
Hao Zhang
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