Unusual Cause of Heart Failure in a Patient with Marfan Syndrome: A Late Complication of Bioprosthetic Valved Graft Replacement

Modification of an Old Technique to Correct Kinking of Tubular Graft Interposed to Reconstruct Ascending Aorta

Cardiac surgeons are occasionally faced with ascending aorta graft kinking following ascending aorta replacement. Although it may be difficult to precisely assess the correct length of the graft during aortic clamping, while performing proximal and distal graft anastomoses on an empty heart, the major reason for graft kinking is its excessive length. Haemolytic anaemia, graft thrombosis or even heart failure have been reported as a consequence of unrecognised and uncorrected kinking of the ascending aortic graft. This paper describes a modification and improvement of an old aortic graft non-clamping technique to solve the problem of kinked tubular graft without resuming cardiopulmonary bypass.