Proximal Anastomosis for the Treatment of Acute Type A Aortic Dissection: An Operative Technical Note

This Technical Note describes a proximal anastomotic technique for supracoronary ascending aortic replacement in acute type A aortic dissection. The method is based on invagination of a short prosthetic graft segment at the sinotubular junction, followed by eversion to create a reinforced proximal cuff. The technique aims to facilitate restoration of aortic valve coaptation, reduce proximal suture-line tension, and improve intraoperative hemostasis in fragile or dissected aortic tissue. The same principle may also be considered in selected elective aortic procedures when reinforcement of the proximal anastomosis is desirable.