[HSF] Aortic Valve Conduit with Tissue Valve

[Ani Anyanwu]

I work in same institution with Professor Griepp and this is what we do

We use a CE perimount 2700 valve because it has a nice sewing ring.

Plegeted inverting or everting sutures through annulus

True size annulus and pick valve of this size.

Select a Hemashield graft 5 mm more than size of selected valve. (I.e 21 mm valve + 26 mm Hemashield). If arch dilated can go up to 7mm but never less than 5 mm - remember the outer diameter of sewing ring is more than stated diameter of valve.

Suture hemashield to sewing ring using running 4/0 prolene. This is a tacking stitch not hemostatic stich so can be generously spaced. Catch one ring of hemashield. Remember to allign one pillar of valve with black line on graft.

Pass sutures through sewing cuff and through hemashield catching 2 rings. Tie down when complete.

Rest as per other Bentalls.

To replace the valve at reop, he incises the dacron then incises the inner sewing ring and the old valve can be lifted out leaving the old sewing ring insitu. A new valve is then easily placed using a running 3/0 prolene suture - takes him about 15 minutes to sew in new valve.

Ani