Modified technique for reconstructing the visceral arteries in thoracoabdominal aortic repair

We present a modified technique for reconstructing the visceral arteries in thoracoabdominal aortic repair. After the proximal and distal anastomosis of a main tubular graft with four pre-sewn side branches, each visceral artery is cannulated and perfused with 25 °C blood (sum total, 800 mL/min). Then, each side branch is placed around the main graft, forming a gently curved loop around it. Finally, the orifice of each visceral artery is sutured to a side branch. This technique prevents kinking of the side branches and enables hemostasis to be secured with a clear view of all the suture lines.