Tube-graft inversion for the construction of an "open" distal anastomosis during ascending aortic replacement: a new technique.

Abstract

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.