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Ann Thorac Surg 2008;86:2023. doi:10.1016/j.athoracsur.2008.04.027
© 2008 The Society of Thoracic Surgeons
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Correspondence

Patch Aortoplasty for Proximal Anastomosis of Coronary Artery Bypass Grafts

Hendrick B. Barner, MD

Division of Cardiothoracic Surgery, St Louis University School of Medicine, 3635 Vista at Grand, St Louis, MO 63110

(Email: hbarner{at}slu.edu).

To the Editor:

Based on experience, we enthusiastically endorse the authors' [1] use of patch aortoplasty for proximal anastomosis of coronary artery bypass grafts and particularly for arterial conduits where even thickening of the aortic wall without significant atherosclerotic change is problematic for long-term patency [2, 3]. Patching is mandatory for more obvious aortic wall disease to avoid early and late closure of the anastomotic orifice. I prefer autologous pericardium, which is also available at most reoperations. Its durability for this purpose is well documented by the Mayo Clinic report [4].


   References
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 References
 

  1. Korach A, Menon P, Oz MS. Patch aortoplasty for proximal anastomosis of coronary artery bypass grafts in patients with complex aortic pathology Ann Thorac Surg 2008;85:1108-1109.[Abstract/Free Full Text]
  2. Kantor K, Barner HB. Improved anastomotic technique for the proximal anastomosis with free internal mammary grafts Ann Thorac Surg 1987;44:556-557.[Abstract/Free Full Text]
  3. Barner HB. Techniques of myocardial revascularizationIn: Edmunds Jr LH, editor. Cardiac surgery in the adult. 1st ed.. New York, NY: McGraw-Hill; 1997. pp. 459-534.
  4. Piehler JM, Danielson GK, Pluth JR, et al. Enlargement of the aortic root or annulus with autologous pericardial patch during aortic valve replacement: long-term follow-up J Thorac Cardiovasc Surg 1983;86:350-358.[Abstract]




This Article
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