Adventitial Inversion with Graft Telescopic Insertion for Distal Anastomosis in Acute Type A Aortic Dissection

Purpose: One current method of anastomosis in aortic dissection type A is the adventitial inversion technique. To improve hemostasis at the anastomotic site, we have developed a novel technique for distal anastomosis involving adventitial inversion employing graft telescopic insertion. Methods: The adventitia was inverted into the aortic lumen and the anastomosis with a Dacron tube-graft was made in a telescopic method, covering the inverted adventitia. Results: Five patients have undergone emergency ascending aortic replacement for aortic dissection by one surgeon using this technique. There have been no reoperations for bleeding or false aneurysm. Conclusion: Complete coverage of the inverted adventitia eliminated the potential risk of thrombus formation. Graft telescopic insertion lead to complete hemostasis.