References
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Acknowledgements: None.
Figure 1. New composite, butterfly wing shaped, valve graft fixated
using a hand-made double sewing cuff.
After transecting downward from the distal end of the composite graft,
circular line along the edge of a sewing cuff was marked on transected
graft. The circle was then cut and a ring-shaped polyterafluoroethylene
graft was sutured at the upper margin of the sewing cuff using a
continuous 4-0 polypropylene suture. Adding an upper sewing cuff to
reinforce suturing using the residual aortic wall.
Figure 2, Schematic views of new composite valve graft and anastomotic
procedures
A hand-made composite valve graft has two sewing cuffs, that is, a lower
sewing cuff (conventional sewing cuff) for annular suturing and an upper
sewing cuff (the added polyterafluoroethylene graft) for reinforcement
suturing. After conventional annular suturing, reinforcement suturing
was performed between the upper sewing cuff and the residual aortic wall
to reduce bleeding at the proximal anastomotic site.
Figure 3. Operation field. A. first annular suturing B. second
reinforcement suturing.