S Shaped Arteriotomy Helps in Better Visualisation of the Corners

Abstract

While performing end to side anastomosis, in small vessels, longitudinal arteriotomy results in a narrow slit due to the pull of the loops (A). This necessitates traction on adventitia to visualise the corners. An S shaped arteriotomy obviates it. A longitudinal arteriotomy of 6 – 8 mm is created. The arteriotomy is then extended about one mm transversely at the corners, in the opposite directions, forming an “S” (B). The dynamics are altered, causing the edges to open spontaneously. A narrow “V” at the corners is transformed into a broad “U” with better visualisation of them. This facilitates the anastomosis.Image 1