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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Frank A. Baciewicz, Jr Irving L. Kron Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baciewicz, F. A. Articles by Kron, I. L. Search for Related Content PubMed PubMed Citation Articles by Baciewicz, F. A., Jr Articles by Kron, I. L.

Ann Thorac Surg 1996;61:1587
© 1996 The Society of Thoracic Surgeons

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Correspondence

Reducing Aortic Root Bleeding

Harper Hospital, 3990 John R, Detroit, MI 48201

To the Editor:

The recent article, ``Reducing Bleeding After Replacement of the Aortic Root,'' by Bayfield and Kron emphasizes the importance of hemostatic anastomoses of the composite graft to the aortic root and left coronary artery to the composite graft.

I have used interrupted pledgeted everting mattress sutures for the composite graft to aortic annulus anastomosis. The technique has the sutures slightly overlapping when placed through the aortic annulus and the sewing ring of the composite graft. Using this technique, I have not found it necessary to sew the remaining stump of the aorta to the composite graft.

When a Cabrol anastomosis to left and right coronary arteries has been fashioned, I use another technique to check for leaks. A small retrograde cardioplegia cannula is inflated in the arm of the graft to the left or right coronary anastomosis. Giving antegrade cardioplegia down each arm before performing the side-to-side anastomosis to the valved conduit checks for leaks at each coronary anastomosis. Assessing the inferior aspect of either coronary anastomosis once the cross-clamp has been removed and the graft distended is difficult. Placing sutures in these same locations off bypass and after protamine has been given can present a challenge.

Reference

1. Bayfield MS, Kron IL. Reducing bleeding after replacement of the aortic root. Ann Thorac Surg 1995;60:1130–1.[Abstract/Free Full Text]

Reply

Department of Surgery, University of Virginia Health Sciences Center, Box 310, Charlottesville, VA 22908

To the Editor:

Mr Bayfield and I appreciate this letter by Dr Baciewicz. We certainly believe that any technique that prevents bleeding should be performed. It takes very little time to sew the second layer. Therefore, we will continue to use it in our practice. We appreciate the interest in our technique.

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Frank A. Baciewicz, Jr Irving L. Kron Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baciewicz, F. A. Articles by Kron, I. L. Search for Related Content PubMed PubMed Citation Articles by Baciewicz, F. A., Jr Articles by Kron, I. L.