General Tips
* General Approach
* Cannulation Sites
* Bevel Your Distal Ascending or Hemi-Arch Anastomosis
* Aortic Wrap
* Carbon Dioxide Flooding of the Pericardial Well
* Innominate Vein Ligation
* Pericardial Bridge for Delayed Sternal Closure
* Pull Hard on Graft to Measure Length
* Reduction of Graft Diameter
* Increase of Graft Diameter
* Reinforcement of Posterior Wall of Aortic Anastomosis
* Retrosternal Sponge Re-entry Technique
* Reinforced Sternal Closure
* The Tightening Stitch
* Towel Clip Technique to Control Re-entry Bleeding
* Turn Off LV Vent Well Before Finishing Last Ascending Suture Line
* Conduct of DHCA
* Clamping the Aorta
o Clamp above the subclavian
o Early Recruitment of Left Subclavian Artery
* Other Cerebral Perfusion Strategies
* Swing Venous Line Down to Expose Aortic Root
* Intraoperative Malperfusion
* Surrounding the Ascending Aorta-Without Injuring the PA
* Do NOT obliterate a chronic flap
* Hugging but not Restricting the Innominate Artery with the Clamp
* Do Not Cut Too Close to the Clamp
* Graft Sizing
* Valerie Stitch for Exposure of the Aortic Root
* Cannulation of Left Inferior Pulmonary Vein
* Left Atrial Cannulation in Atrial Fibrillation
* The E-Rule: Never Start LA-FA Artery Perfusion w/o the Aorta Clamped
* Remember the Pulmonary Artery for Venous Return
* Mobilize the Posterior Wall Completely
* Mobilize the Descending Aorta from the Esophagus
* Sub-adventitial Hematoma
* Sienna graft for Mega-aorta
* The Inclusion Anastomotic Technique
* Big Needle for Thick Aortas
* Aneurysms of the Branches of the Aortic Arch
* Attaching Arch Graft to Ascending Graft (Configurations)
* BioGlue on Graft-to-Graft Anastomoses
* Lung Adhesions
* Adherence of Aneurysm to Chest Wall
* Reoperative Adhesions
* Extracting old prosthetic valves
Ascending Aorta and Aortic Arch
* Aortic Morphology Determines Extent of Resection
* Use the Corner of the Commissure to Advantage
* Aortic Valve Repair
* Ascending Aortic Replacement (*deeper stitches on non-coronary sinus)
* Composite Graft (Aortic Root Replacement) (Bentall Procedure)
* Composite Graft (Aortic Root Replacement) (Bentall Procedure)
* V-Shaped Aortic Root Remodeling
* Valve-Sparing Aortic Root Replacement
* Arch Replacement Options (2-vessel, 3-vessel, trifurcated graft)
* Standard (Non-Frozen) Elephant Trunk Procedure
* Retrieving the Elephant Trunk-Four Options
* Stand-alone Elephant Trunk
* Acute Type A Aortic Dissection
o General Perspective
o Cannulation
o Sandwich Options
o Proximal Anastomosis
o Distal Anastomosis
o Elephant Trunk
o Frozen elephant trunk
o Abdomen first
o BioGlue
o Late Degeneration (Proximal)(Distal)
o A Note About Timing of Surgery for Acute Type A Aortic DIssection
* Ross procedure
Descending and Thoracoabdominal Aorta
* Descending Aortic Replacement
o Incision
o Proximal Anastomosis: Site Selection
o DHCA for upper descending aortic surgery
o Massively dilated upper descending aorta
o Safety suggestions
o Watch the nerves
o Vertical veins
o Thoracic duct
o Anastomotic reinforcement
* Acute Type B Aortic Dissection: Clinical Perspectives to Guide Surgery
* Fenestration Procedure
* Thoracoabdominal Aortic Replacement
o Exposure
o Perfusion
o Visceral anastomoses
Cobrahead Graft
o Figure-of-Eight Stitches for Intercostals
o Clipping the Spinal Arteries from the Outside
o Methods of intercostal artery attachment
o Paraplegia Prevention-General Approach to Spinal Cord Protection
Pre-Operative Spinal Artery Visualization
o Post-Operative Care After Descending/Thoracoabdominal Aortic Replacement
* Abdominal aortic replacement
* Visceral artery aneurysms
* Pulmonary Artery Aneurysms
Vascular Rings
* General Comments
* Vascular Rings and Kommeril's Diverticula
o General Comments
o Double Aortic Arch
o Right Aortic Arch with Aberrant Left Subclavian
o Left Aortic Arch with Aberrant Right Subclavian
o Kommeril's Diverticulum