Complete replacement of the ascending aorta with reimplantation of the coronary arteries

The "Button Inside" Technique for the Aortic Root Replacement: A Modified Button Technique

“…From the beginning of 1990, the button technique 2-5 is generally used for the rattachment of the coronary arteries to the composite valve graft in the ARR except for cases where Cabrol or Piehler technique is needed. 6,7 The button technique is widely performed because of more advantages with respect to the reimplantation of in situ coronary ostia described in the original Bentall operation. However, despite a reduced incidence of early and late complications, the reattachment of coronary arteries plays a key role in the results of the ARR.…”

“…From the beginning of 1990, the button technique [2][3][4][5] is generally used for the reattachment of the coronary arteries to the composite valve graft in the aortic root replacement (ARR) except for cases where Cabrol or Piehler technique is needed. 6,7,8,9 A new button technique for the reattachment of coronary arteries from inside to outside of the prosthesis is described ( Fig. 1).…”

Diagnosis and Management of Cerebral Malperfusion Phenomena During Aortic Dissection Repair by Transesophageal Doppler Echocardiographic Monitoring

“…During rewarming, a composite valve graft was inserted and the coronary arteries were reattached with 1 0-mm Dacron grafts according to the Cabrol technique. 6 The patient recovered and was discharged from the hospital without any neurological complications. Follow-up TEE showed residual dissection of the distal aorta with good flow in the true lumen and in the arch vessels.…”

Rescue Coronary Artery Bypass Grafting (CABG) after Aortic Composite Graft Replacement

“…In redo cases or massive aneurysms, in which there may be fixation or extensive distortion of the coronary ostia, adequate mobilization of the coronary ostia may not be possible, and a Cabrol anastomosis with an interposition graft may be preferable. 9 Once the diagnosis of coronary insufficiency has been suspected, we do not generally recommend takedown of the buttons and their re-reimplantation. It can be very difficult to ascertain (three dimensionally) exactly what aspect of the anastomosis of the coronary buttons should be improved.…”