Aortotomy
With cardioplegia and ACP successfully established, aortic resection is
performed to facilitate the introduction of the FET stent graft, and
subsequently, the proximal aortic graft. In Z-2-FET, the aortic arch is
fully resected from the sinotubular junction to the proximal Zone 3
border, and the descending thoracic aorta (DTA) is then examined via
angioscope.14, 16 However, for Z-0-FET, an aortotomy
is usually performed up to 15 mm distal to the sinotubular junction and
10-20 mm proximal to the origin of the brachiocephalic trunk, allowing
the removal of a significant portion of the ascending aorta.
Subsequently, both Yamamoto et al. and Jakob et al.reapproximate the walls of the remaining proximal ascending aorta with
surgical glue and staying sutures.16, 17 Aortic valve
resuspensions can also be performed to preserve valve
function.17