Early Non-Invasive Angiographic Results of the “Button Inside” Technique for the Reattachment of Coronary Arteries in the Aortic Root Replacement

Abstract

Background and Aim: The Button technique was the operative technique generally used for the reimplantation of coro- nary arteries in the aortic root replacement because of reduced anastomotic complications respect to the original wrapped operation described by Bentall and De Bono. The “Button Inside” technique is a modified Button technique recently performed in all consecutive series of patients operated on aortic root replacement at our Institution. In this study we report early postoperative angiographic results of patients operated on aortic root replacement using the “But- ton Inside” technique. Methods: Magnetic Resonance Imaging angiography was achieved in all patients operated on aortic root replacement. Morphological characteristics of the site of coronary buttons reattachment were accurately evaluated. Results: No postoperative anastomotic leakages were detected at the site of coronary buttons anastomosis. Moreover, in this first series of postoperative control aneurisms of coronary buttons were not detected. Conclusions: Early postoperative non-invasive angiographic results of the “Button Inside” technique are encouraging. This surgical approach for the reattachment of coronary arteries is suggested in aortic root replacement when is possible to mobilize coronary arteries in order to reduce coronary artery anastomotic complications.

Share and Cite:

C. Canosa, G. Nasso, G. Restaino, C. Filippo, P. Spatuzza, N. Testa, G. Sallustio and F. Alessandrini, "Early Non-Invasive Angiographic Results of the “Button Inside” Technique for the Reattachment of Coronary Arteries in the Aortic Root Replacement," World Journal of Cardiovascular Surgery, Vol. 2 No. 2, 2012, pp. 24-27. doi: 10.4236/wjcs.2012.22008.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] C. Canosa, G. Nasso, C. M. De Filippo, et al., “The ‘Button Inside’ Technique for the Aortic Root Replacement: A Modified Button Technique,” Journal of Cardiac Surgery, Vol. 21, No. 4, 2006, pp. 407-409. doi:10.1111/j.1540-8191.2006.00256.x
[2] M. R. Prince, “Gadolinium-Enhanced MR Angiography,” Radiology, Vol. 191, No. 1, 1994, pp. 155-164.
[3] E. S. Crawford, L. G. Svensson, J. S. Coselli, et al., “Surgical Treatment of Aneurysm and/or Dissection of the Ascending Aorta, Transverse Aortic Arch, and Ascending Aorta and Transverse Aortic Arch,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 98, No. 5, 1989, pp. 659-674.
[4] N. T. Kouchoukos, T. H. Wareing, S. F. Murphy, et al., Sixteen-Year Experience with Aortic Root Replacement. Results of 172 Operations,” Annals of Surgery, Vol. 214, No. 43, 1991, pp. 308-320. doi:10.1097/00000658-199109000-00013
[5] L. G. Svensson, E. S. Crawford, K. R. Hess, et al., “Composite Valve Graft Replacement of the Proximal Aorta: Comparison of Techniques in 348 Patients,” The Annals of Thoracic Surgery, Vol. 54, No. 3, 1992, pp. 427-439. doi:10.1016/0003-4975(92)90432-4
[6] D. Pacini, F. Ranocchi, E. Angeli, et al., “Aortic Root Replacement with Composite Valve Graft,” The Annals of Thoracic Surgery, Vol. 76, No. 1, 2003, pp. 90-98. doi:10.1016/S0003-4975(03)00265-0
[7] C. Cabrol, A. Pavie, I. Gangjbakhch, et al., “Complete Replacement of the Ascending Aorta with Reimplantation of the Coronary Arteries,” Journal of Thoracic and Cardiovascular Surgery, Vol. 81, No. 2, 1981, pp. 309-315.
[8] M. Ito, T. Kazui, Y. Tamia, et al., “Redo Composite Valve Graft Replacement,” Journal of Cardiac Surgery, Vol. 16, No. 3, 2001, pp. 240-246. doi:10.1111/j.1540-8191.2001.tb00514.x
[9] H. Bentall and A. De Bono, “A Technique for Complete Replacement of the Ascending Aorta,” Thorax, Vol. 23, No. 4, 1968, pp. 338-339. doi:10.1136/thx.23.4.338
[10] A. D. Milano, S. Pratali, G. Mecozzi, et al., “Fate of Coronary Ostial Anastomoses after the Modified Bentall Procedure,” The Annals of Thoracic Surgery, 2003, Vol. 75, No. 6, pp. 1797-1802. doi:10.1016/S0003-4975(03)00015-8
[11] R. Fattori, B. Descovich, P. Bertaccini, et al., “Composite Graft Replacement of the Ascending Aorta: Leakage Detection with Gadolinium-Enhanced MR Imaging,” Radiology, Vol. 212, No. 2, 1999, pp. 573-577.
[12] T. G. Mesana, T. Caus, J. Y. Gaubert, et al., “Late Complications after Prosthetic Replacement of the Ascending Aorta: What Did We Learn from Routine Magnetic Resonance Imaging Follow-Up?” European Journal CardioThoracic Surgery, Vol. 18, No. 3, 2000, pp. 313-320. doi:10.1016/S1010-7940(00)00512-1
[13] A. Panos, B. Amahzoune, J. Robin, et al., “Influence of Technique of Coronary Artery Implantation on Long-Term Results in Composite Aortic Root Replacement,” The Annals of Thoracic Surgery, Vol. 72, No. 5, 2001, pp. 1497-1501. doi:10.1016/S0003-4975(01)03052-1
[14] L. J. Meijboom, G. J. Nollen, N. Merchant, et al., “Frequency of Coronary Ostial Aneurysms after Aortic Root Surgery in Patients with the Marfan Syndrome,” American Journal of Cardiology, Vol. 89, No. 9, 2002, pp. 11351138. doi:10.1016/S0002-9149(02)02290-7

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.