A modified technique of anastomosis between dissected aortic stump and a Dacron tube graft: the suture line inclusion technique.

Abstract

We describe a modified technique of anastomosis between dissected aortic stump and a Dacron tube graft (Sulzer Vascutek, Renfrewshire, Scotland) with the aim of minimizing suture line complications. After a stented graft was implanted into the stump or a Teflon felt strip (C.R. Bard, Inc, Tempe, AZ) was circumferentially placed on the intima of the stump, a series of nonpledgeted 2-0 horizontal mattress sutures were placed from inside to outside. Certain tension on those sutures should be created to keep the intraluminal Teflon felt strip in place. The end of the Dacron tube graft was everted outward, and its double-folded end was anastomosed to the aortic stump with incorporation of the proximal end of the stented graft or the intraluminal Teflon felt strip. The everted Dacron portion was then returned to its original position, and the previously placed horizontal mattress sutures were appropriately passed through the corresponding site, and all sutures were securely tied in place. Our initial application showed that this simple technique provides a more hemostatic anastomosis.