In GSH, distal anastomosis is performed with marking of the sewing collar and native aorta at every quadrant to ensure precise anastomotic ratio. Further, all around the sewing collar is trimmed 5 mm away from the circumference of the native aorta to avoid folding of the collar, called dog-ear phenomenon for hemostasis of distal anastomosis before distal anastomosis. After continuous suture, the reinforcement sutures are always made all around the anastomosis site with 3-0 pledgeted Prolene™.
Minimizing the graft manipulation is important to prevent damage to uncoated graft and reduce the graft oozing, including clamping the site as far away from the joint as possible and the site of incision.
In GSH, not only in TAR FET, but also in total arch replacement, the plant-based hemostatic powder agent was used for hemostasis with satisfactory results. If more control on graft oozing is required, the graft-oozing point is sutured with 5-0 Prolene™ pledgeted sutures.
Minimizing the graft manipulation is important to prevent damage to uncoated graft and reduce the graft oozing, including clamping the site as far away from the joint as possible and the site of incision.
In GSH, not only in TAR FET, but also in total arch replacement, the plant-based hemostatic powder agent was used for hemostasis with satisfactory results. If more control on graft oozing is required, the graft-oozing point is sutured with 5-0 Prolene™ pledgeted sutures.
