Aortic Root Reconstruction with a New Dacron Graft Featuring Prefabricated Coronary Side Branches

Abstract

Background: Coronary button reimplantation can represent a technical challenge of aortic root reconstruction that can be associated with significant morbidity and mortality. With the goal of simplifying coronary reimplantation and reducing the incidence of related complications, we designed a new Dacron graft with prefabricated coronary branches to minimize coronary artery mobilization and prevent the potential mechanical complications of reattachment to the body of the graft. Methods: Between June 2010 and May 2012, we implanted the graft in eight patients (six males, two females) ranging in age from 42-68 years (mean, 54 years). Six procedures were modified Bentall reconstructions, and two procedures were valvesparing root replacements using the reimplantation technique. Results: There were no complications and no morbidity or mortality related to coronary reattachment. All patients were alive and doing well at a mean follow-up of 26 months (range, 17-38 months). At an extended mean follow-up of 42 months (range, 25-56 months), one patient died of stroke-related complications. No radiologic or clinical evidence of impairment of coronary perfusion was identified in any patient. Conclusions: The use of this new graft model may simplify the technique of root reconstruction and potentially lower the incidence of mechanical complications related to coronary button reimplantation.

Research Progress on Aortic Root Aneurysms

“…Cabrol surgery is commonly used for internal coronary artery tear, especially in aortic dissection [ 59 – 61 ]. Due to the displacement of the coronary artery opening, severe calcification of the aortic vessel wall around the coronary artery opening, and severe adhesion during secondary surgery, it is difficult to isolate the coronary artery opening and anastomosis.…”