Advantages of upper brachial artery cannulation in aortic surgery.

Background: The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings.

A simple technique to reduce tension on coronary button anastomosis in aortic root surgery.

The permanency of the coronary ostial anastomosis is an important predictor of morbidity in aortic root surgery. We introduced a technique to reduce coronary reimplantation-related complications in aortic surgery. We believe that plicating the folds of the graft at both sides of the coronary ostial anastomosis reduces the tension on the suture line and may be advantageous to avoid pseudoaneurysm formation, detachment of the coronary button from the graft, distortion of the coronary geometry, or bleeding from the suture line.

Surgical approaches in left anterior descending artery in-stent stenosis.

Background: In-stent stenosis remains the major disadvantage of coronary interventions. Extensive applications of the intracardiac devices especially involving long segments of coronary arteries have resulted in an increase in the number of cases of in-stent stenosis. That may require aggressive surgical approaches.