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How To Do It

A Novel Arch-First T-Graft Technique for Extensive Aortic Arch Reconstruction

^a Cardiovascular Center of Taichung Veterans General Hospital, Taichung City, Taiwan
^b Division of Cardiovascular Surgery of Chi-Mei Hospital, Yungkang City, Tainan County, Taiwan
^c National Yang Ming University School of Medicine, Taipei, Taiwan

Accepted for publication November 9, 2007.

^_* Address correspondence to Dr Wei, Cardiovascular Center of Taichung Veterans General Hospital, 160 Taichung-Kang 3rd Rd, Taichung City, 40705, Taiwan (Email: weihaoji{at}yahoo.com.tw).

To reduce the morbidity and mortality associated with extensive aortic arch replacement, the reconstruction technique is the most important part of the treatment. By refining the present techniques, we developed an arch-first T-graft technique. This technique provides a more reasonable arrangement of procedures, least brain ischemic time, less low-body ischemic time, and an easy way of distal aortic anastomosis. This method is performed through a traditional median sternotomy, keeps the lung free from manipulation, and avoids severe kink of major vascular grafts.