• Journal of Chest Surgery
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• v.29 no.6
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• pp.646-650
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• 1996

The usual methods for the re-attachment of coronary ostia to the ascending aortic conduit have several disadvantages and potential complications. A novel, straight forward technique is described that allows for tension free anastomoses to be co structed with minimal risk of blood loss and a reduced risk of reoperation for false aneurysms at the anastomoses. We performed this technique for the treatment of a 40-yrs-old male patient of acute aortic dissection (Stanford Type A, DeBakey Type I) with severe aortic re- gurgitation. The techinque comprised anastomosis of a beveled interposition tube graft to the left main coronary artery ostium, and its proximal anastomosis to the ascending aortic graft after seating the com- posite valve graft in the prepared aortic annulus. With this technique, the low-Iying or distant left main coronary ostium can be easily reattached to the ascending conduit without undue tension.

• Journal of Rhinology
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• v.25 no.2
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• pp.123-129
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• 2018

Background and Objectives: Endoscopic repair of cerebrospinal fluid (CSF) leak can avoid morbidity of open approaches and has shown a favorable success rate. Free mucosal graft is a good method, and multi-layered repair is more favorable. The inferior turbinate has been commonly utilized for the free mucosal graft, but we newly designed it as a bone-periosteal-mucosal composite graft for multilayered reconstruction. Subjects and Method: Four subjects with a skull base defect were treated with this method. The inferior turbinate was partially resected including the conchal bone and was trimmed according to defect size. Both bony parts and periosteum were preserved on the basolateral side of the mucosa as a composite graft. The graft was applied to the defect site using an overlay technique. Results: All cases were successfully repaired without any complications. Three of them had a defect size greater than 10-12 mm, and the graft stably repaired the CSF leakage. Conclusion: Endoscopic repair of CSF leakage using inferior turbinate composite graft is a simple and easy method and would be favorable for defect sizes greater than 10 mm.