An effective method for improving hemostasis in aortic root replacement with a composite graft.

Hemostasis during aortic root replacement with a composite graft, consisting of a separate Dacron graft and a valve, was markedly improved by using a supra-annular aortic wall reinforcing suture (SAWR). Between February 1994 and January 1998, 14 consecutive patients (10 men and 4 women) underwent replacement of the aortic valve and ascending aorta with the SAWR technique. No intraoperative bleeding of the aortic proximal suture line or early death occurred in this group. No patient required reoperation for bleeding of anastomoses. Three of 10 patients who underwent elective operations were operated on successfully without blood transfusion. In addition, no clinical complications related to the SAWR technique were observed in the follow-up period. We conclude that the SAWR technique can be performed easily and may be an effective method for improving proximal hemostasis.