title: Reverse U aortotomy (Kırali incision) for aortic valve replacement.
abstract: The presence of patent vein grafts on the proximal aorta may cause technical difficulties during reoperations for aortic valve replacement after previous coronary artery bypass surgery. A 65-year-old man underwent reoperation for aortic valve replacement two years after his first open heart surgery (valve-sparing aortic root replacement and aorta-right coronary artery saphenous vein graft). The aortotomy incision was started approximately 2 cm above the proximal anastomosis and continued down at both sides until the prosthetic graft. The reverse U aortotomy prevents unnecessary and risky manipulations of proximal anastomoses, provides perfect exposure, and can be used securely during reoperative aortic valve surgery.
authors.affiliation: Department of Cardiovascular Surgery, Koşuyolu Heart and Research Hospital, Istanbul, Turkey imkbkirali@yahoo.com.
authors.forename: Kaan
authors.initials: K
authors.lastname: Kırali
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D001026:Coronary Artery Bypass; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Aortic valve insufficiency; cardiovascular surgical procedures; coronary artery bypass; heart valve prosthesis implantation