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Simple and Reliable Distal Anastomosis for Total Aortic Arch Replacement

Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan

For reprint information contact: Akihiko Ohkado, MD, Tel: 078 855 9151, Fax: 078 251 5033, Email: aki-ohkado{at}ohkado-heart-clinic.com, OHKADO Heart Clinic, Art Center of Kobe Medical Mall 4F, 7-1-13, Kumochibashi-dori, Chuo-ku, Kobe, Hyogo 651-0055, Japan.

In total aortic arch replacement, distal aortic anastomosis is often remarkably difficult because of the deep operative field. Once bleeding from the anastomotic area occurs, it is intractable not only because of technical problems but also decreased coagulability due to deep hypothermia and the fragility of the aortic wall. We describe a simple but reliable strategy for distal anastomosis, which is unique with regard to the approach to the anastomotic area and the anastomotic method.