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Operative images. (A) An inverted U-shaped incision (green arrow) is made in the posterior wall of the aorta. (B) The flap created from this U-shaped incision is bridged to the anterior wall of the proximal main pulmonary artery (mPA), ensuring adequate space around the coronary arteries. (C) A patch is created using the pulmonary arterial wall on the peripheral side of the mPA and sutured to cover the bridging flap. (D) A schematic of this technique.
