초록접수 현황
| 17F-116 | 포스터 발표 |
Placement of a Horizontal Running Suture at the Hemostatic Line using Inverted Graft Technique: A Technical Option during Aortic Replacement
Sun Kyun Ro, MD, PhD, Seunghyuk Nam, MD.
Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : An over-and-over running suture is a widely used end-to-end anastomotic technique during aortic replacement. We have experienced some cases that a horizontal running suture rather than the over-and-over running suture was placed at the hemostatic suture line when a graft-to-aorta anastomosis was performed using an inverted graft technique.
Methods : This suture technique was applied to four patients, one of whom was diagnosed as chronic aortic aneurysm and three of whom as acute aortic dissection, during both proximal and distal aortic anastomoses. An inverted graft was inserted into the aortic lumen and a 1 cm wide Teflon felt strip was placed outside the aorta. The inner graft, the aortic wall, and the outer felt strip were tightly put together by circumferentially placing a single horizontal running suture (Figure 1). The inverted graft was then withdrawn from the aorta and the graft interposition was completed by a graft-to-graft anastomosis as a final step.
Results : In all patients, additional hemostatic stitches were not needed on the graft-to-aorta anastomoses. There was no postoperative bleeding complication and the postoperative computed tomographic findings showed no anastomotic pseudoaneurysm during the follow-up period.
Conclusion : The inverted graft technique with the placement of a horizontal running suture may be a safe, hemostatic, and reproducible technical option during proximal or distal aortic anastomosis, even though the graft-to-graft anastomosis is supposed to be added. Further study concerning anastomotic suture techniques is necessary for dealing with issues on hemostasis during aortic replacement.
Methods : This suture technique was applied to four patients, one of whom was diagnosed as chronic aortic aneurysm and three of whom as acute aortic dissection, during both proximal and distal aortic anastomoses. An inverted graft was inserted into the aortic lumen and a 1 cm wide Teflon felt strip was placed outside the aorta. The inner graft, the aortic wall, and the outer felt strip were tightly put together by circumferentially placing a single horizontal running suture (Figure 1). The inverted graft was then withdrawn from the aorta and the graft interposition was completed by a graft-to-graft anastomosis as a final step.
Results : In all patients, additional hemostatic stitches were not needed on the graft-to-aorta anastomoses. There was no postoperative bleeding complication and the postoperative computed tomographic findings showed no anastomotic pseudoaneurysm during the follow-up period.
Conclusion : The inverted graft technique with the placement of a horizontal running suture may be a safe, hemostatic, and reproducible technical option during proximal or distal aortic anastomosis, even though the graft-to-graft anastomosis is supposed to be added. Further study concerning anastomotic suture techniques is necessary for dealing with issues on hemostasis during aortic replacement.
책임저자: Sun Kyun Ro
Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Sun Kyun Ro, E-mail : skro@hanyang.ac.kr