Insertion Multi-Parachute Suturing and Knotting (IMS-K) Technique for Aortic Surgery.

Abstract

Successful surgical interventions for aortic surgery, such as hemiarch repair and total arch replacement, pivot on the foundation of optimal anastomosis. We propose an alternative approach to anastomosis. The "insertion multi-parachute suturing and knotting" (IMS-K) technique entails the deployment of two parachute sutures, which can be effectively employed for both proximal and distal anastomoses. The first suture is applied loosely to the posterior half of the anastomosis and subsequently parachuted down, tightening the suture with a nerve hook. The second suture replicates the procedure in the anterior half of the anastomosis, loosely securing it in a similar manner and tightening it with a nerve hook at the end. As a result, the artificial graft is completely inserted into the aorta with a substantial grip. This technique simplifies the aortic anastomosis by ensuring procedural simplicity while minimizing bleeding risk, thus potentially advancing surgical outcomes.