Patch Aortoplasty for Proximal Anastomosis of Coronary Artery Bypass Grafts

Abstract

Based on experience, we enthusiastically endorse the authors' [1Korach A. Menon P. Oz M.S. Patch aortoplasty for proximal anastomosis of coronary artery bypass grafts in patients with complex aortic pathology.Ann Thorac Surg. 2008; 85: 1108-1109Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar] use of patch aortoplasty for proximal anastomosis of coronary artery bypass grafts and particularly for arterial conduits where even thickening of the aortic wall without significant atherosclerotic change is problematic for long-term patency [2Kantor K. Barner H.B. Improved anastomotic technique for the proximal anastomosis with free internal mammary grafts.Ann Thorac Surg. 1987; 44: 556-557Abstract Full Text PDF PubMed Scopus (12) Google Scholar, 3Barner H.B. Techniques of myocardial revascularization.in: Edmunds Jr, L.H. Cardiac surgery in the adult. 1st ed. McGraw-Hill, New York, NY1997: 459-534Google Scholar]. Patching is mandatory for more obvious aortic wall disease to avoid early and late closure of the anastomotic orifice. I prefer autologous pericardium, which is also available at most reoperations. Its durability for this purpose is well documented by the Mayo Clinic report [4Piehler J.M. Danielson G.K. Pluth J.R. et al.Enlargement of the aortic root or annulus with autologous pericardial patch during aortic valve replacement: long-term follow-up.J Thorac Cardiovasc Surg. 1983; 86: 350-358PubMed Google Scholar]. Based on experience, we enthusiastically endorse the authors' [1Korach A. Menon P. Oz M.S. Patch aortoplasty for proximal anastomosis of coronary artery bypass grafts in patients with complex aortic pathology.Ann Thorac Surg. 2008; 85: 1108-1109Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar] use of patch aortoplasty for proximal anastomosis of coronary artery bypass grafts and particularly for arterial conduits where even thickening of the aortic wall without significant atherosclerotic change is problematic for long-term patency [2Kantor K. Barner H.B. Improved anastomotic technique for the proximal anastomosis with free internal mammary grafts.Ann Thorac Surg. 1987; 44: 556-557Abstract Full Text PDF PubMed Scopus (12) Google Scholar, 3Barner H.B. Techniques of myocardial revascularization.in: Edmunds Jr, L.H. Cardiac surgery in the adult. 1st ed. McGraw-Hill, New York, NY1997: 459-534Google Scholar]. Patching is mandatory for more obvious aortic wall disease to avoid early and late closure of the anastomotic orifice. I prefer autologous pericardium, which is also available at most reoperations. Its durability for this purpose is well documented by the Mayo Clinic report [4Piehler J.M. Danielson G.K. Pluth J.R. et al.Enlargement of the aortic root or annulus with autologous pericardial patch during aortic valve replacement: long-term follow-up.J Thorac Cardiovasc Surg. 1983; 86: 350-358PubMed Google Scholar].