A Modified Wrapping-internal Shunt Method for Hemostasis in Bentall Procedure

Abstract

Introduction:Blindly punching between aorta and right atrium is dangerous. In that case, there is concerned about leakage between the two referred isolate parts. Besides, as the routine imaging techniques (echocardiography or computer tomography) are incompetent to detect this particular anatomic structure preoperatively, the intraoperative inspection appears necessary. Our method is useful for identifying this innate fusion plane.Case report:The thrombosis surrounding prosthesis was detected in the first ultrasound examination after the operation, which was considered to be an indication of successful hemostasis. As the innate fusion between aorta and right atrium appears no rare, the selective creation of left-to-right internal shunt is a valuable maneuver for controlling bleeding in appropriate cases.

Total proximal anastomosis detachment after classical bentall procedure

“…The wrapping technique originally described by Bentall can lead to increased pressure around the valved composite conduit, particularly at anastomotic sites. Some surgeons still use the wrapping technique despite the zero-porosity collagen and gel-impregnated grafts [14] .…”