Femoral cannulation is also a principal technique used
in CPB during aortic dissection repair. Proximal perfusion
at the distal aortic arch pushes the inner true lumen
towards the outer layer, therefore, decreasing the size of
the false lumen and reducing side-branch malperfusion
from the preceding dissection.3 Other options for CPB
cannulation in Stanford Type A aortic dissection repair
include axillary artery and dissected ascending aortic
cannulation. The axillary artery has proven to be cumbersome
and time-consuming for surgeons, especially in
obese patients, and this technique is not ideal in cardiac
tamponade when the patient needs immediate CPB.4
Cannulating the dissected ascending aorta has the advantage
of perfusing the true lumen.5 However, this method
carries the risk of aortic rupture and distal embolization.