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Miami Minimally Invasive Valves
Joseph Lamelas, MD
Dedicated to the Advancement of Minimally Invasive Cardiac Surgery
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Posts tagged as cardiac surgery

In some minimally invasive cases where the ascending aorta is replaced at the level of the STJ and the AV is sparred (not a David procedure, a supra-coronary replacement), I find it valuable to use 2 separate grafts. One segment of graft is initially anastomosed to the hemi -arch or the distal ascending aorta and the other segment of graft to the STJ.  These are then beveled and sewn together.  This 2 graft technique is especially helpful if the proximal anastomosis ( STJ) is far away.

 The technique that I have used to suture this proximal anastomosis entails inverting the proximal graft into the root and suturing it with a running suture. Once complete the small segment of graft is pulled from the root and there is a very hemostatic closure. The pictures below demonstrate the technique.

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