Cannulation strategies for aortic surgery: which is the best one?

The choice of the optimal arterial cannulation strategy for surgery on proximal aorta and arch remains a controversial area and a subject of intense debate. The search for the best cannulation strategy for aortic surgery assumes increasing importance due to its impact on clinical outcomes. Several cannulation strategies have been proposed to establish cardiopulmonary bypass (CPB) for aortic surgery and each one of these has its pros and cons. These cannulation strategies can be broadly classified into central and peripheral cannulation strategies. Sites of central cannulation (CC) include the ascending aorta itself as well as the innominate, subclavian and axillary artery whereas femoral artery cannulation is synonymous with peripheral cannulation (PC).