Replacement of the ascending aorta and aortic valve with a composite graft in patients with nondisplaced coronary ostia.

Composite graft replacement of the ascending aorta and aortic valve is indicated for a variety of conditions affecting the aortic root. In most cases, cephalad displacement of the coronary ostia permits direct reimplantation of the ostia into the composite graft. Occasionally, anatomical factors exist that preclude the safe advancement of the ostia to the graft for direct anastomosis. A method for dealing with this problem utilizing a short interposed polytetrafluoroethylene graft between coronary ostia and composite graft is presented.