Repair of posterior aortic anastomotic leaks.

AFTER COMPLETION of an aortic anastomosis, particularly the kind that is required for cardiac trans-plantation or excision of the ascending aorta, persistent leak at the posterior wall suture line (Fig. lA) may be difficult to repair became of poor exposure. We successfully performed the following technique after other efforts at hemostasis had failed. A Aortic anastomosis showing persistent leak of posterior wall "'/JJJ)))ij1!;;: "'t/;')))}J; o Needles drawn through \SIOOd Jet t t B TECHNIQ,UE Straight swaged needles are required at both ends of the suture. If these are not available, curved vascular needles are straightened out by bending. The straight needles are inserted posteriorly, one transversely picking up tissue just superior to the defective anastomosis and the other taking a simi-'Straight needles inserted posteriorly Median sagital section of aortic anastomosis FIG. 1. Repair of posterior aortic anastomotic leaks with a mattress suture technique.