Adventitial inversion with graft telescopic insertion for distal anastomosis in acute type a aortic dissection.
OBJECTIVE
One current method of anastomosis in aortic dissection type A is the adventitial inversion technique. To improve hemostasis at the anastomotic site, we have developed a novel technique for distal anastomosis involving adventitial inversion employing graft telescopic insertion.


METHODS
The adventitia was inverted into the aortic lumen and the anastomosis with a Dacron tube-graft was made in a telescopic method, covering the inverted adventitia.


RESULTS
Five patients have undergone emergency ascending aortic replacement for aortic dissection by one surgeon using this technique. There have been no reoperations for bleeding or false aneurysm.


CONCLUSIONS
Complete coverage of the inverted adventitia eliminated the potential risk of thrombus formation. Graft telescopic insertion lead to complete hemostasis.
University Cardiovascular Center Freiburg-Bad Krozingen, Freiburg, Germany.
Bartosz
B
Rylski
Matthias
M
Siepe
Philipp
P
Blanke
Wulf
W
Euringer
Joachim
J
Schoellhorn
Friedhelm
F
Beyersdorf
D000208:Acute Disease; D063194:Adventitia / Q000601:surgery*; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D016896:Treatment Outcome
D011093:Polyethylene Terephthalates