Ann Thorac Surg 2007;84:712
© 2007 The Society of Thoracic Surgeons
Correspondence
Tube Graft Inversion for Facilitated Aortic Anastomosis: A Previously Described Technique
Aristotelis Panos, MD, PD
Clinic for Cardiovascular Surgery, University Hospital of Geneva, 24, Rue Micheli-du-Crest, Geneva, 14 1211 Switzerland
(Email: a.panos{at}bluewin.ch).
To the Editor:
I read with great interest the article by Alexiou and Sosnowski [1] describing tube-graft inversion for the construction of an open distal anastomosis as a new technique for ascending aortic replacement. However I would like to point out that this technique is not new at all, despite the fact that the author uses a single side branch tube graft for replacement of the ascending aorta. Indeed Borst and colleagues [2] first published this technique for construction of an "elephant trunk" and evaluated it in a subsequent publication [3]. The same principle of this technique was published by Prêtre [4] for performance of a proximal anastomosis in the setting of an aortic dissection. In these descriptions the authors used a suture to help them evert the graft after completion of the anastomosis. The side branch used by Alexiou and Sosnowski [1] may not be mandatory because antegrade perfusion can be established through right axillary cannulation for cardiopulmonary bypass. Since 1998 our team routinely uses this technique with excellent results. In conclusion, I agree with the authors of the present article that this technique is safe, hemostatic, and fully reproducible, but certainly it is not new.
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References
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- Alexiou C, Sosnowski A. Tube-graft inversion for the construction of an "open" distal anastomosis during ascending aortic replacement: a new technique Ann Thorac Surg 2007;83:326-328.[Abstract/Free Full Text]
- Borst H-G, Walterbrusch G, Schaps D. Extensive aortic replacement using elephant trunk prosthesis Thorac Cardiovasc Surg 1983;31:37-40.[Medline]
- Heinemann M, Buehner B. Use of elephant trunk technique in aortic surgeryJurmann M, Borst H-G Ann Thorac Surg 1995;60:2-7.[Abstract/Free Full Text]
- Prêtre R. Performance of a safe proximal anastomosis in aortic dissection Ann Thorac Surg 1998;65:1798-1799.[Abstract/Free Full Text]
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