A technique for coronary artery reimplantation in composite aortic root replacement

Currently, three techniques are used for reimplantation of coronary arteries following the insertion of a composite aortic valve graft: Bentall, aortic button, and Cabral interposition graft. We have utilized an alternative technique based on the creation of an inverted U-shaped flap, which is then reflected and sutured to an appropriately sized coronary button. The technique is simple, obviates the needs for coronary mobilization, and assures a tension-free anastomosis and accessible suture line.