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Ann Thorac Surg 2007;83:326-328
© 2007 The Society of Thoracic Surgeons

How To Do It

Tube-Graft Inversion for the Construction of an "Open" Distal Anastomosis During Ascending Aortic Replacement: A New Technique

Christos Alexiou, FRCS, PhD, Andrzej W. Sosnowski, MD, FRCS*

Department of Cardiac Surgery, Glenfield Hospital, University Hospitals of Leicester, Leicester, United Kingdom

Accepted for publication March 10, 2006.

* Address correspondence to Dr Sosnowski, Glenfield Hospital, Groby Rd, Leicester, LE3 9QP United Kingdom (Email: andrzej.sosnowski{at}uhl-tr.nhs.uk).

For the construction of a distal "open" anastomosis during ascending aortic replacement, a tube-graft is placed opposite to the transected aorta. We describe an alternative technique. The tube-graft is inverted and positioned within the aortic arch in a way that brings the entire circumference of the distal end of the tube-graft next to the circumference of the transected aorta. An end-to-end anastomosis is then fashioned with a running suture, the needle of which goes through the aorta and the tube-graft in a single pass. This technique permits easy, accurate, and fast suture placement, producing a hemostatic distal anastomosis within a short circulatory arrest time.




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