Brachio-cephalic revascularization from the intrathoracic aorta: use of a T-piece graft

Ready made T-piece dacron grafts have been available for some time for use in axillo-bifemoral procedures. This report illustrates the use of such a graft in two cases of brachiocephalic revascularization from the intrathoracic aorta. In each case the aortic arch branches were severely diseased. The technique allows placement of the 8 mm diameter limb on the ascending aorta deep to the sternum, where, because of its lack of bulk, it can sit without compression. The 8 mm side piece can be manoeuvred to follow any direction required and avoids placement of an anastomosis in an otherwise awkward area. If required, a third limb can be sutured onto the proximal limb beyond the region where compression would occur.