title: Modified Cabrol's technique for composite replacement of the aortic valve and ascending aorta.
abstract: Composite replacement of the ascending aorta and aortic valve with coronary reimplantation can be complicated by intraoperative hemorrhage from the coronary ostial anastomoses and proximal aortic suture line. Exposure and repair of these suture lines may be quite difficult after the termination of bypass in the intact aortic root. Cabrol originally described connecting the coronary ostia by separate Dacron graft, which was then anastomosed side-to-side to the aortic conduit, and the entire repair wrapped in the aneurysm wall to control bleeding. This article describes a modification of Cabrol's technique in which coronary ostial buttons are mobilized and the entire aortic wall resected. This procedure has been used in five patients with varied pathology, with no perioperative deaths and one minor intraoperative neurological event. The greater ease of operation and improved hemostasis afforded by the technique described in this article warrant its consideration in patients requiring aortic root replacement, and may prove particularly helpful in complex cases and reoperations.
authors.affiliation: Department of Surgery, University of Iowa Hospital and Clinics, Iowa City 52242-1062.
authors.forename: R P
authors.initials: RP
authors.lastname: Embrey
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001011:Aorta / Q000601:surgery*; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003331:Coronary Vessels / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011093:Polyethylene Terephthalates
chemical_list: D011093:Polyethylene Terephthalates