The composite aortic wall graft technique: an option for a short coronary artery bypass graft.
CONCLUSIONS
During coronary artery bypass graft (CABG) surgery, the saphenous vein is sutured through its proximal segment to the aorta. Intimal hyperplasia is one of the possible causes of graft occlusion. Notably, blood turbulence can induce wall shear stress that may also play an important role in this process.


OBJECTIVE
We propose a new technique for performing proximal anastomosis to avoid CABG failure.


METHODS
An 80 kg pig was subjected to open heart surgery. Four stitches were placed in the anterior ascending aorta, which formed a 2 cm by 4 cm patch. This patch was isolated through the application of a tangential clamp that was oriented parallel to the axis of the aorta. After releasing the patch, which was held to the aorta through its cranial end pedicle, the rims were sutured to each other creating a conduit with a length of 4 cm and an internal diameter of 4 mm. The rest of the aortotomy was closed by placing a direct suture between its rims.


RESULTS
This novel technique created an "in situ" aortic wall graft that was 4 cm long and characterized as being of uniform 4 mm caliber.
Oliveira
João Bosco de
JB
Hospital Beneficência Portuguesa, Cardiologia, São Paulo/SP, Brazil.
Rocha e Silva
Roberto
R
Martins
Dennys Marcel Sanches
DM
De Mola
Ricardo
R
Carvalho
Marcos Vinicius Henriques de
MV
D000818:Animals; D001011:Aorta / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000379:methods*; D006965:Hyperplasia / Q000517:prevention & control; D023421:Models, Animal; D013552:Swine; D017539:Tunica Intima / Q000473:pathology*
Ann Med. 1994 Apr;26(2):95-100
8024734
Am J Physiol Heart Circ Physiol. 2006 Jul;291(1):H283-95
16489100
Biomed Eng Online. 2005 Mar 04;4:14
15745458
Clinics (Sao Paulo). 2007 Dec;62(6):725-30
18209915
Surgery. 1972 Dec;72(6):1007-17
5087270
Ann Thorac Surg. 2009 Jan;87(1):19-26.e2
19101262
Clinics (Sao Paulo). 2005 Jun;60(3):227-32
15962084
Circulation. 1979 Aug;60(2):250-9
312703
Rev Bras Cir Cardiovasc. 2008 Jan-Mar;23(1):114-7
18719837
Rev Bras Cir Cardiovasc. 2009 Apr-Jun;24(2):138-42
19768291