Improving Circulatory Support in Cases of Acute DeBakey Type I Aortic Dissection: A Novel Arterial Cannulation Approach and Its Effects on Perfusion and Minimizing Complications

Objective . Proposing a novel arterial cannulation technique for acute DeBakey type I aortic dissection with severe aortic arch and branch involvement to enhance CPB effectiveness and reduce organ malperfusion complications. Methods . The technique involves retrograde insertion of an arterial perfusion tube into the aortic arch through the left common carotid artery. Extracorporeal circulation is established, and total aortic arch replacement with deep hypothermic systemic circulation and a frozen elephant trunk stent placement are performed to restore lower body perfusion. Results . Six patients with severe aortic arch and branch involvement underwent the new arterial cannulation technique. All patients had smooth postoperative recoveries without significant complications. Conclusion . The novel arterial cannulation technique shows promise in managing acute DeBakey type I aortic dissection with extensive vascular involvement, reducing complications, and enhancing patient outcomes. Further validation with a larger patient cohort is needed to confirm its effectiveness and safety. If successful, this technique could become a valuable addition to treatment strategies for improved outcomes.