Novel Valved Graft Modification of Cabrol Fistula for Bleeding After Aortic Root Surgery

Surgical Treatment of Acute Type A Aortic Dissection with 18-Litre Bleeding

“…We compared our conventional data on transfusion supply of patients who underwent surgery for AAAD with data presented by Chemtob et al 5 The volume of blood components that we used was several times less. Even though such surgical techniques as various modification of Cabrol's shunt 8 have significantly improved the control of bleeding they, in our opinion, do not always guarantee sufficient hemostasis, especially in patients with coagulopathy.…”

Utilization of the Cabrol shunt in aortic surgery-from the ‘wrap technique’ to veno-arterial extracorporeal membrane oxygenation setting : A narrative review

“…He favored the use of a valved bovine jugular graft (Contegra ® ) to ensure unidirectional flow and eliminate venous back bleeding into the perigraft space. (15) As evidenced by the aforementioned reports, the Cabrol shunt is a very effective method to control bleeding after complex aortic surgery used in the event of failure of other methods and severe coagulopathy. The bleeding was immediately controlled in all cases after the construction of the shunt, and none of the patients was reported to require re-exploration for hemorrhage.…”

“…The bleeding was immediately controlled in all cases after the construction of the shunt, and none of the patients was reported to require re-exploration for hemorrhage. The patency of the shunt has been evaluated by Doppler transthoracic echocardiography (4,6,10,11,15,16), CT (10,13,14,17), and/or MRI (18).…”

“…The Cabrol shunt was first described in 1981 as a technique used for the control of postoperative bleeding in aortic surgery (1). Over the years, the original technique has undergone several modifications, some due to the lack of redundant native aorta to wrap once the preservation of the aneurysmal wall was abandoned in favor to complete resection of the aneurysmal sac, and others to adapt the technique to particular challenges of the case to repair (i.e., the presence of adhesions on the right atrium) (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).We conducted a literature review of the different uses and modifications of the Cabrol shunt through the years, as well as an analysis of the reported results and complications (Table 1). In addition, we report our experience of the Cabrol shunt in the setting of venoarterial extracorporeal membrane oxygenation (VA-ECMO) following complex aortic surgery.…”

Mechanism to Valve a Cabrol Fistula for Bleeding Control

“…The inflow end of the Contegra valved graft has been anastomosed to the top, center of the pericardial patch. The outflow end of the Contegra graft is being anastomosed to the innominate vein under side-biting control (reproduced with permission from [1]).…”