Composite graft replacement of the aortic root: 'button' technique

Presentation of the 'button' technique for composite graft replacement of the aortic root: dilated ascending aorta is removed, both coronary ostia are dissected free, a composite graft is fixed to the aortic annulus with interrupted mattress sutures, coronary arteries are implanted into the graft with a running stitch, and distal portion of the graft is connected to the distal aorta by means of a running suture. Additional techniques for improvement of hemostasis are shown, and an overview of the literature is presented.