AORTIC ANASTOMOSIS MADE EASIER

During repair of abdominal aortic aneurysm, the proximal graft-aortic anastomosis is usually created following the technique described by Creech in 1966; the posterior wall of the aorta is not disturbed, thus providing a substantive bulk of tissue to which the graft can be sutured. Because of restricted access it is necessary to insert the needle into the posterior aortic wall and the graft separately before parachuting the latter into position. Moreover, when the posterior wall is smooth and flat, it is difficult to obtain adequate bites of tissue and to retrieve the needle easily. The technique described in this paper was designed to allow simultaneous needle placement in the graft and aortic wall while maintaining the principles of the Creech method.