title: Modification of the Bentall operation using the proximal double sewing technique without excision of leaflets.
abstract: We present a report on reinforcement of the proximal anastomosis during the Bentall operation. The aortic wall was excised with a 5-mm remnant, and aortic valve leaflets were preserved. Interrupted horizontal mattress sutures (2-0 Polyestel) reinforced with pledgets were placed. The composite graft was placed at the intraannular position inside of the preserved leaflets. The aortic valve leaflets were then pasted to the sewing cuff with fibrin glue. A running suture with 4-0 monofilament was placed between the remnant of the aortic wall and the peripheral side of the sewing cuff wrapped with native aortic valve leaflets.
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima, Osaka 534-0021, Japan. shibata@msic.med.osaka-cu.ac.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shibata
authors.forename: Kazushige
authors.initials: K
authors.lastname: Inoue
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ikuta
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Bito
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mizokuchi
mesh_terms: D001011:Aorta / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods*; D013536:Suture Techniques