[HSF] Aortic purse strings in thin large aortas.

[Edward Bender]

I'm sure that this is old fashioned, but I use 2-0 ethibond for  
aortic pursestring stitches.  If the aortic wall is thin (I can not  
put a partial thickness stitch in), I use pledgets on my outer of 2  
pursestrings.  There is a pledget between all bites in the aortic  
wall.  Pledget material is either pericardium or felt.  If I don't  
place pledgets, then after decannulation I use a 4-0 prolene with  
pericardium or left-over vein as pledgets.

Ed Bender, MD


On Dec 2, 2006, at 1:27 PM, sekhar le wrote:

> We use 5/0 prolene for all aortic purse strings. We use   finer  
> sutures with the idea that needle holes of bigger sutures cause  
> more bleeding   before   they are not tied.
> we do not use pledgets  with the idea that when there is bleeding  
> the pledgets obscure the  exact source of bleeding.
>
> With this approach we do not have problems in   normal sized aortas  
> but we do have occasional problems in thin large aortas.
>
> I would like to know what others use for large thin aortas.
>
>
> Dr Sekhar
>
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