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Ann Thorac Surg 2003;76:949-951
© 2003 The Society of Thoracic Surgeons

How to do it

A new approach for proximal anastomosis in type "A" acute aortic dissection: prosthesis eversion

Andrea Rignano, MDa, Guido C. Keller, MDa, Michele Carmo, MDa*, Giovanni B. Anguissola, MDb, Piergiorgio G. Settembrini, MDa

a Department of Vascular Surgery, Ospedale S. Carlo Borromeo, University of Milan, Milan,, Italy
b Department of Intensive Care Therapy, Ospedale Maggiore di Milano–IRCCS, University of Milan, Milan, Italy

Accepted for publication February 14, 2003.

* Address reprint requests to Dr Carmo, Department of Vascular Surgery, Ospedale S. Carlo Borromeo, via Pio II, 3, 20153 Milan, Italy
e-mail: michele.carmo{at}unimi.it

One of the crucial aspects of surgical repair of type A aortic dissection is to achieve hemostasis of the anastomosis. Furthermore, the possibility of improving the suture with additional stitches is often technically demanding. We, therefore, describe a new surgical technique for the proximal anastomosis, positioning the prosthesis within the left ventricle. We present our series of 6 patients treated with this new technique. The immediate results confirmed the efficacy, speed, and simplicity of the technique. During long-term follow-up no patient showed significant residual aortic valve incompetence.




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