This Article Full Text (PDF) 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): Marco Pocar Andrea Moneta Francesco Donatelli Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pocar, M. Articles by Donatelli, F. Search for Related Content PubMed PubMed Citation Articles by Pocar, M. Articles by Donatelli, F. Related Collections Great vessels Related Article

ICVTS on-line discussion A

IRCCS MultiMedica, Sesto San Giovanni, Milano, Italy

Aortic arch reconstruction utilizing a simple reversed graft trimming technique

eComment: We congratulate Salemi and Pettersson [1] for reporting this simple pitfall to obtain a correct graft orientation in ascending aortahemiarch replacement. The issue of a correct graft curvature is evident when considering that prosthetic vascular grafts (not only branched) specifically designed to match arch anatomy are commercially available. However, the latter might not always be included in standard vascular graft sets at all institutions, and may not be cost-effective.

Alternatively, kinking can be reduced by plication sutures or abolished with wedge resection(s) of the inner curvature of the graft, but these approaches are more or less cumbersome, especially in an emergency setting.

After having read this description, one of us (M.P.) recently applied this trimming technique in an emergency operation for acute type A dissection. The solution is straightforward and geometrically convincing, resulting in an almost vertical ascending aorta with no kinking. The near-rectilinear reconstructed aorta determines a more laminar blood flow with a lower stress on the suture lines. This reduces hemostatic hazards and might possibly promote the obliteration of the false channel in an acutely dissected aorta.

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1. Salemi A, Pettersson GB. Aortic arch reconstruction utilizing a simple reversed graft trimming technique. Interact CardioVasc Thorac Surg 2006; 5:247–248.[Abstract/Free Full Text]

This Article Full Text (PDF) 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): Marco Pocar Andrea Moneta Francesco Donatelli Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pocar, M. Articles by Donatelli, F. Search for Related Content PubMed PubMed Citation Articles by Pocar, M. Articles by Donatelli, F. Related Collections Great vessels Related Article